Information Collection

Application data for public-sector organizations

IC 199189 under ICR 202101-0920-014 · OMB 0920-0909.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0909 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0909 Application data for public-sector organizations	Form and Instruction
0920-0909 DPRP Application Form Att 4 A Application for CDC Recognition Form_2021 DPRP Standards_11-30-20.pdf	Form and Instruction
0920-0909 DPRP Application Form Att 4 A Application for CDC Recognition Form_2021 DPRP Standards_11-30-20.pdf	Form and Instruction

IC Title:

Application data for public-sector organizations

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	0920-0909	DPRP Application Form	Att 4 A Application for CDC Recognition Form_2021 DPRP Standards_11-30-20.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 68

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	90	-60	150
Annual IC Time Burden (Hours)	90	-60	150
Annual IC Cost Burden (Dollars)	0	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.