OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – Individuals/households (NIEHS)

IC 246516 under ICR 202103-0925-003 · OMB 0925-0648.

Documents and Forms
Document Name
Document Type
Form
Form
Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – Individuals/households (NIEHS)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 1 PEPH Aware Act Use survey PEPH_Aware-Act-Use_Survey_Final_06-20-2018v3.docx Yes Yes Fillable Fileable

Health Health Care Services

 

292 0
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 292 0 292 0 0 0
Annual IC Time Burden (Hours) 24 0 24 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
fast track for Partnerships for Environmental Public Health (PEPH) Aware-Act-Use – Individuals/households Fast Track _PEPH Ind. and Households.docx 03/31/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.