Information Collection

Chronic obstructive pulmonary disease National Action Plan Tracking System - Preliminary Model (Federal Government))

IC 241710 under ICR 202003-0925-002 · OMB 0925-0766.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0766 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Chronic obstructive pulmonary disease National Action Plan Tracking System - Preliminary Model (Federal Government))	Form and Instruction
1 Blueprint Handout Blueprint handout rev6 20200206 (005)_NA (1).docx	Form and Instruction
COPD Clearance_NHLBI_Final (1).docx Mini SSA	IC Document

IC Title:

Chronic obstructive pulmonary disease National Action Plan Tracking System - Preliminary Model (Federal Government))

Agency IC Tracking Number:

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	1	Blueprint Handout	Blueprint handout rev6 20200206 (005)_NA (1).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

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	20	20
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Mini SSA	COPD Clearance_NHLBI_Final (1).docx	05/06/2020

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