CSP Annual Progress Report

[NCIPC] Performance Monitoring of CDC’s Comprehensive Suicide PreventionProgram —

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1368 can be found here:

Documents and Forms

Document Name Document Type
Attachment D_ Partners Portal.docx Other-WORD
Attachment D_ Partners Portal.docx Other-WORD
Attachment D1_ Screen Shots Partner's Portal.docx CSP 2020 Annual Progress Report (screenshots) IC Document
Attachment D1_ Screen Shots Partner's Portal.docx CSP 2020 Annual Progress Report (screenshots) IC Document

Information Collection (IC) Details

IC Title:	CSP Annual Progress Report	Agency IC Tracking Number:	0920-21GY

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Attachment D_ Partners Portal.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	17	6	11
Annual IC Time Burden (Hours)	204	72	132
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
CSP 2020 Annual Progress Report (screenshots)	Attachment D1_ Screen Shots Partner's Portal.docx	01/12/2022

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