Information Collection

NCCDPHP Data Management Plan

IC 239417 under ICR 202001-0920-014 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-19BLE NCCDPHP Data Management Plan	Form and Instruction
0920-19BLE DMP Template 19BLE Att 2a DMP Template Final (1).docx	Form and Instruction
0920-19BLE CSTLTS_DMP Template 19BLE Att 2b_CSTLTS_DMP Template Final (1).docx	Form and Instruction
0920-19BLE NCEH_DMP Template 19BLE Att 2c_NCEH_DMP Template Final.docx	Form and Instruction
0920-19BLE NCIPC DMP Template 19BLE Att 2d_NCIPC DMP Template Final.docx	Form and Instruction
0920-19BLE NCBDDD DMP Template Final 19BLE Att 2e_NCBDDD DMP Template Final.docx	Form and Instruction
0920-19BLE NCEZID-DHQP DMP Template Final 19BLE Att 2f_NCEZID-DHQP DMP Template Final.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? Yes

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-19BLE	DMP Template	19BLE Att 2a DMP Template Final (1).docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-19BLE	CSTLTS_DMP Template	19BLE Att 2b_CSTLTS_DMP Template Final (1).docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-19BLE	NCEH_DMP Template	19BLE Att 2c_NCEH_DMP Template Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-19BLE	NCIPC DMP Template	19BLE Att 2d_NCIPC DMP Template Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-19BLE	NCBDDD DMP Template Final	19BLE Att 2e_NCBDDD DMP Template Final.docx	Yes	Yes	Fillable Fileable
Form and Instruction	0920-19BLE	NCEZID-DHQP DMP Template Final	19BLE Att 2f_NCEZID-DHQP DMP Template Final.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,190

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,190	1,190
Annual IC Time Burden (Hours)	1,190	1,190
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.