OD2A-LOCAL Evaluation & Performance Measurement Plan Template

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

OMB: 0920-1283

IC ID: 257748

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OD2A-LOCAL Evaluation & Performance Measurement Plan Template 0920-1283
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-n/a OD2A-LOCAL Evaluation and Performance Measuring Plan Template Attachment 3h_OD2A-LOCAL Evaluation and Performance Measurement Plan Template.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

40 0
   
State, Local, and Tribal Governments
 
   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 40 0 -26 66 0 0
Annual IC Time Burden (Hours) 14 0 -250 264 0 0
Annual IC Cost Burden (Dollars) 0 0 -8,802 8,802 0 0

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