Information Collection

NBCCEDP Quarterly Program Update

IC 250010 under ICR 202111-0920-005 · OMB 0920-1046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1046 NBCCEDP Quarterly Program Update	Form and Instruction
0920-1046 NBCCEDP Quarterly Program Update Att 7 - NBCCEDP Quarterly Program Update.docx	Form and Instruction
0920-1046 NBCCEDP Quarterly Program Update Att 7 - NBCCEDP Quarterly Program Update.docx	Form and Instruction
Att 7a - NBCCEDP Quarterly Program Update (screenshots).docx NBCCEDP Quarterly Program Update (screenshots)	IC Document
Att 7a - NBCCEDP Quarterly Program Update (screenshots).docx NBCCEDP Quarterly Program Update (screenshots)	IC Document
Att 7b - NBCCEDP Quarterly Program Update Administration Email.docx NBCCEDP Quarterly Program Update Administration Email	IC Document
Att 7b - NBCCEDP Quarterly Program Update Administration Email.docx NBCCEDP Quarterly Program Update Administration Email	IC Document
Att 7c - NBCCEDP Quarterly Program Update Pre-Administration Email.docx NBCCEDP Quarterly Program Update Pre-Administration Email	IC Document
Att 7c - NBCCEDP Quarterly Program Update Pre-Administration Email.docx NBCCEDP Quarterly Program Update Pre-Administration Email	IC Document
Att 7d - NBCCEDP Quarterly Program Update Reminder Email.docx NBCCEDP Quarterly Program Update Reminder Email	IC Document
Att 7d - NBCCEDP Quarterly Program Update Reminder Email.docx NBCCEDP Quarterly Program Update Reminder Email	IC Document

IC Title:

NBCCEDP Quarterly Program Update

Agency IC Tracking Number:

0920-1046

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	0920-1046	NBCCEDP Quarterly Program Update	Att 7 - NBCCEDP Quarterly Program Update.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

Number of Respondents for Small Entity: 0

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
Annual Number of Responses for this IC	280	280
Annual IC Time Burden (Hours)	149	149
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NBCCEDP Quarterly Program Update (screenshots)	Att 7a - NBCCEDP Quarterly Program Update (screenshots).docx	11/02/2021
NBCCEDP Quarterly Program Update Administration Email	Att 7b - NBCCEDP Quarterly Program Update Administration Email.docx	11/02/2021
NBCCEDP Quarterly Program Update Pre-Administration Email	Att 7c - NBCCEDP Quarterly Program Update Pre-Administration Email.docx	11/02/2021
NBCCEDP Quarterly Program Update Reminder Email	Att 7d - NBCCEDP Quarterly Program Update Reminder Email.docx	11/02/2021

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