Information Collection Request

[NCIPC] Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement

ICR 202301-0920-001 · OMB 0920-1283 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-n/a OD2A-LOCALData Management Plan Template Form and Instruction New Available
Form 0920-n/a OD2A-LOCAL Data Management Plan Template Form and Instruction New Repair queued
Form 0920-n/a OD2A-LOCAL Evaluation and Performance Measuring Plan Template Form and Instruction New Available
Form 0920-n/a OD2A-LOCAL Evaluation & Performance Measurement Plan Template Form and Instruction New Repair queued
Form 0920-1283 OD2A-S Data Management Plan Template Form and Instruction Modified Available
Form 0920-1283 OD2A-S Data Management Plan Template Form and Instruction Modified Repair queued
Form 0920-1283 OD2A-S Annual Performance Report and Work Plan Form and Instruction Modified Available
Form 0920-1283 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction Modified Repair queued
Form 0920-1283 Activity Progress Report and Work Plan Tool Form and Instruction Modified Available
Form 0920-1283 Activity Progress Report and Work Plan Tool - Annual Performance Report Form and Instruction Modified Repair queued
OD2A-LOCAL Annual Performance Report and Work Plan Form and Instruction Modified Available
OD2A-LOCAL Annual Performance Report and Work Plan Form and Instruction Modified Repair queued
Form 0920-1283 Organizational Capacity Assessment - Annual Reporting Form and Instruction Modified Available
Form 0920-1283 Organization Capacity Assessment - Annual Reporting Form and Instruction Modified Repair queued
Form 0920-1283 OD2A-S Annual Performance Measuring Report and Work Plan (OD2A-S) Form and Instruction Modified Available
Form 0920-1283 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction Modified Repair queued
Form 0920-1283 Evaluation and Performance Measuring Plan Template - Annual Reporting Form and Instruction Modified Available
Form 0920-1283 Evaluation and Performance Measuring Plan Template Form and Instruction Modified Repair queued
Attachment 4_List of Data Collection Instrument Requests.docx Supplementary Document Uploaded 2023-01-11 Repair queued
Att 7 Crosswalk of the four required reporting.docx Supplementary Document Uploaded 2019-10-16 Repair queued
Attachment 7_Research Determination.pdf Supplementary Document Uploaded 2023-01-11 Repair queued
Attachment 5_PIA.pdf Supplementary Document Uploaded 2023-01-05 Repair queued
Attachment B_Published 60dy FRN.pdf Supplementary Document Uploaded 2023-01-05 Repair queued
Attachment 2 List of Funded Jurisdictions.docx Supplementary Document Uploaded 2023-01-05 Repair queued
Att 1 Authorizing Legislation.doc Supplementary Document Uploaded 2019-10-16 Repair queued
SSB_1283 OD2A Progress Reporting_final.docx Supporting Statement B Uploaded 2023-01-11 Repair queued
SSA_1283_OD2A Progress Reporting_011123.docx Supporting Statement A Uploaded 2023-01-11 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
257750 OD2A-LOCAL Data Management Plan Template Form and Instruction NewOD2A-LOCALData Management Plan Template
257750 OD2A-LOCAL Data Management Plan Template Form and Instruction New
257748 OD2A-LOCAL Evaluation & Performance Measurement Plan Template Form and Instruction NewOD2A-LOCAL Evaluation and Performance Measuring Plan Template
257748 OD2A-LOCAL Evaluation & Performance Measurement Plan Template Form and Instruction New
238174 OD2A-S Data Management Plan Template Form and Instruction ModifiedOD2A-S Data Management Plan Template
238174 OD2A-S Data Management Plan Template Form and Instruction Modified
238173 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction ModifiedOD2A-S Annual Performance Report and Work Plan
238173 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction Modified
238172 Activity Progress Report and Work Plan Tool - Annual Performance Report Form and Instruction ModifiedActivity Progress Report and Work Plan Tool
238172 Activity Progress Report and Work Plan Tool - Annual Performance Report Form and Instruction Modified
238171 OD2A-LOCAL Annual Performance Report and Work Plan Form and Instruction ModifiedOD2A-LOCAL Annual Performance Report and Work Plan
238171 OD2A-LOCAL Annual Performance Report and Work Plan Form and Instruction Modified
238170 Organization Capacity Assessment - Annual Reporting Form and Instruction ModifiedOrganizational Capacity Assessment - Annual Reporting
238170 Organization Capacity Assessment - Annual Reporting Form and Instruction Modified
238169 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction ModifiedOD2A-S Annual Performance Measuring Report and Work Plan (OD2A-S)
238169 (OD2A-S) Annual Performance Report and Work Plan Form and Instruction Modified
238168 Evaluation and Performance Measuring Plan Template Form and Instruction ModifiedEvaluation and Performance Measuring Plan Template - Annual Reporting
238168 Evaluation and Performance Measuring Plan Template Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2026 36 Months From Approved 05/31/2023
471 0 286
1,343 0 1,342
0 0 44,740





Reginfo record details
9
table that charts list of burden
IC Title Form No. Form Name
(OD2A-S) Annual Performance Report and Work Plan 0920-1283
(OD2A-S) Annual Performance Report and Work Plan 0920-1283
Activity Progress Report and Work Plan Tool - Annual Performance Report 0920-1283
Evaluation and Performance Measuring Plan Template 0920-1283
OD2A-LOCAL Annual Performance Report and Work Plan n/a
OD2A-LOCAL Data Management Plan Template 0920-n/a
OD2A-LOCAL Evaluation & Performance Measurement Plan Template 0920-n/a
OD2A-S Data Management Plan Template 0920-1283
Organization Capacity Assessment - Annual Reporting 0920-1283

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 471 286 0 79 106 0
Annual Time Burden (Hours) 1,343 1,342 0 -290 291 0
Annual Cost Burden (Dollars) 0 44,740 0 -54,876 10,136 0


Reginfo record details
  No