NOA for change

NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

08/10/2016

Department of Health and Human Services
Centers for Disease Control and Prevention
FOR CERTIFYING OFFICIAL:

Beth Killoran

FOR CLEARANCE OFFICER:

Darius Taylor

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
08/10/2016
ACTION REQUESTED:

No material or nonsubstantive change to a currently approved collection

TYPE OF REVIEW REQUESTED:

Regular

ICR REFERENCE NUMBER:

201608-0920-004

AGENCY ICR TRACKING NUMBER:

16AWO

TITLE:

Well-Integrated Screening and Evaluation for Women Across the Nation(WISEWOMAN) Reporting
System
LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved without change
OMB CONTROL NUMBER:

0920-0612

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE: 12/31/2016

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

Previous

63

1,344

0

New

63

1,344

0

Change due to New Statute

0

0

0

Change due to Agency Discretion

0

0

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Difference

TERMS OF CLEARANCE:

Terms of the previous clearance remain in effect.

OMB Authorizing Official:

Dominic J. Mancini
Acting Deputy Administrator,
Office Of Information And Regulatory Affairs

List of ICs
IC Title

Form No.

Form Name

Combined MDE for Screening 0920-0612, 0920-0612, 0920- Attachment 3a WISEWOMAN
and Assessment MDE and
0612
MDE Version 9, Attachment 3b
Lifestyle Program MDE
Summary of MDE Changes,
WISEWOMAN Program MDE
Manual_ Version 9.0_July
2013 (revised)
Annual Progress Report

CFR Citation