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Organization Capacity Assessment - Annual Reporting
[NCIPC] Monitoring and Reporting for the Overdose Data to Action Cooperative Agreement
OMB: 0920-1283
IC ID: 238170
OMB.report
HHS/CDC
OMB 0920-1283
ICR 202301-0920-001
IC 238170
( )
Documents and Forms
Document Name
Document Type
Form 0920-1283
Organization Capacity Assessment - Annual Reporting
Form and Instruction
0920-1283 Organizational Capacity Assessment - Annual Reporting
Attachment 3b_Organizational Capacity Assessment - Annual Reporting.pdf
Form and Instruction
0920-1283 Organizational Capacity Assessment - Annual Reporting
Attachment 3b_Organizational Capacity Assessment - Annual Reporting.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Organization Capacity Assessment - Annual Reporting
Agency IC Tracking Number:
0920-1283
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0920-1283
Organizational Capacity Assessment - Annual Reporting
Attachment 3b_Organizational Capacity Assessment - Annual Reporting.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
66
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 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
66
0
44
0
0
22
Annual IC Time Burden (Hours)
22
0
0
0
0
22
Annual IC Cost Burden (Dollars)
0
0
-733
0
0
733
Documents for IC
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.