Information Collection

Annual Survey of NBCCEDP Grantees' Program Implementation

IC 213483 under ICR 201805-0920-008 · OMB 0920-1046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Annual Survey of NBCCEDP Grantees' Program Implementation	Form
Annual Survey of NBCCEDP Grantees' Program Implementatio Attachment D2 - Data Collection Instrument Web Version.pdf	Form
Attachment D1 - Data Collection Instrument - MS Word Version.docx Annual Survey - word	IC Document

IC Title:

Annual Survey of NBCCEDP Grantees' Program Implementation

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Voluntary

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	none	Annual Survey of NBCCEDP Grantees' Program Implementation	Attachment D2 - Data Collection Instrument Web Version.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 67

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-67	67
Annual IC Time Burden (Hours)	-45	45
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Annual Survey - word	Attachment D1 - Data Collection Instrument - MS Word Version.docx	10/14/2014

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