Attachment G - Privacy Act Checklist
Preventive Health and Health Services (PHHS) Block Grant– Extension – Center for State, Tribal, Local and Territorial Support (CSTLTS), Centers for Disease Control and Prevention (CDC).
CDC is requesting a three-year approval for an extension of an already approved information collection request to continue the PHHS Block Grant Management Information System (BGMIS) for three years. CDC will continue to use BGMIS to monitor awardee progress, identify activities and personnel supported with Block Grant funding, conduct awardee compliance reviews, and promote the use of evidence based guidelines and interventions. There are no changes to the number of respondents or the estimated annual burden per respondent. There are no changes to BGMIS data elements. The Work Plan and the Annual Report will be submitted annually. The estimated burden per response for the work plan is 20 hours and the estimated burden per response for the Annual Report is 15 hours.
The Privacy Act does not apply. The Privacy Act does not apply. No personally identifiable information will be collected.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Adzua Abdullah-Gilliam |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |