Information Collection

OT18-1802: Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation's Health

IC 251589 under ICR 201902-0920-022 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1050 Survey Questionnaire OT18-1802: Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation's Health	Form and Instruction
0920-1050 Survey Questionnaire Attachment C. REDCap Survey Questions.pdf	Form and Instruction
Attachment A. OT18-1802 Recipient List.pdf Recipient List	IC Document
Attachment B. Survey Invitation Email.pdf Survey Email Invite	IC Document
Attachment D. REDCap Survey Screenshots_with Instructions.pdf Survey Questionnaire Screenshots	IC Document
OMB Control Header and Burden Statement.docx OMB Control Header and Burden Statement	IC Document
OT18-1802 SA_Customer Service 1050 GenIC Clearance Template_02.03.2022_final.docx GenIC Request Template	IC Document

IC Title:

OT18-1802: Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation's Health

Agency IC Tracking Number:

0920-1050-22CS

IC Status: New

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 and Instruction	0920-1050				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 39

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	39	39
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Recipient List		02/14/2022
Survey Email Invite		02/14/2022
Survey Questionnaire Screenshots		02/14/2022
OMB Control Header and Burden Statement		02/14/2022
GenIC Request Template		02/14/2022

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

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