Information Collection

Data Elements for All CPC Programs: Semi-annual Reporting

IC 220441 under ICR 201711-0920-015 · OMB 0920-0841.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0841 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Data Elements for All CPC Programs: Semi-annual Reporting	Form and Instruction
Chronic Disease MIS: Comprehensive Cancer Control Attachment 4a. MIS screenshots for OMB_Feb.pptx	Form and Instruction

IC Title:

Data Elements for All CPC Programs: Semi-annual Reporting

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	Chronic Disease MIS: Comprehensive Cancer Control	Attachment 4a. MIS screenshots for OMB_Feb.pptx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	22	22
Annual IC Time Burden (Hours)	44	44
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.