Information Collection Request

National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities

ICR 202009-0920-022 · OMB 0920-1046 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Clinic-level Cervical Cancer Screening Data Form and Instruction Modified Available
Clinic-level Breast Cancer Screening Data Form and Instruction Modified Available
NBCCEDP Annual Grantee Survey Form and Instruction Modified Available
OMB Request for Adding Question to NBCCEDP Data Collections for COVID-19_Sept 25 2020.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-09-28 Available
Att 11_DP17-1701 Awardee Program List_09282018.docx Supplementary Document Uploaded 2018-10-24 Repair queued
Att 10_0920-1046 PIA 8-21-18.pdf Supplementary Document Uploaded 2018-10-24 Available
Att 9_684 Form.pdf Supplementary Document Uploaded 2018-10-24 Available
Att 8_60-Day Federal Register Announcement.pdf Supplementary Document Uploaded 2018-10-24 Available
Att 7d_NBCCEDP Clinic-Level Data Collection Reminder Email.docx Supplementary Document Uploaded 2018-10-24 Available
Att 7c_NBCCEDP Clinic-Level Data Collection Introductory Email.docx Supplementary Document Uploaded 2018-10-24 Repair queued
Att 6b_NBCCEDP Grantee Survey Reminder Email.docx Supplementary Document Uploaded 2018-10-24 Repair queued
Att 6a_NBCCEDP Grantee Survey Introductory Email.docx Supplementary Document Uploaded 2018-10-24 Repair queued
Att 5_NBCCEDP Evaluation Question Matrix.docx Supplementary Document Uploaded 2018-10-24 Repair queued
Att 4_EBI Logic Models.pdf Supplementary Document Uploaded 2018-10-24 Available
Att 3_NBCCEDP Logic Model.pdf Supplementary Document Uploaded 2018-10-24 Available
Att 2_Breast and Cervical Cancer Prev and Trt Act of 2000.pdf Supplementary Document Uploaded 2018-10-24 Available
Att 1_Authorizing Legislation.pdf Supplementary Document Uploaded 2018-10-24 Available
SS Part B_NBCCEDP_09282018.docx Supporting Statement B Uploaded 2018-10-24 Available
SS Part A_NBCCEDP_09282018.docx Supporting Statement A Uploaded 2018-10-24 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
233708 Clinic-level Cervical Cancer Screening Data Form and Instruction Modified
233707 Clinic-level Breast Cancer Screening Data Form and Instruction Modified
233706 NBCCEDP Annual Grantee Survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
11/30/2021 11/30/2021 11/30/2021
910 0 910
764 0 683
38,976 0 38,976





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 910 910 0 0 0 0
Annual Time Burden (Hours) 764 683 0 81 0 0
Annual Cost Burden (Dollars) 38,976 38,976 0 0 0 0


Reginfo record details
  No