Information Collection Request

[NCCDPHP] Sealant Efficiency Assessment for Locals and States (SEALS)

ICR 202309-0920-005 · OMB 0920-1289 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-1289 Program Administration -Child Aggregate Screens (SSP Local Administrator) Form and Instruction Modified Repair queued
Form 0920-1289 Program Administration - Program Options and Cost Options (SSP Local Administrator) Form and Instruction Modified Missing upstream
Form 0920-1289 SEALS Administration - Add User/Program/School (SSP Local Administrator) Form and Instruction Modified Available
Form 0920-1289 Add Program and Add User - State Sealant Administrator Form and Instruction Modified Repair queued
SEALS SSB Final.docx Supporting Statement B Uploaded 2019-11-18 Missing upstream
SEALS SSA.101123.docx Supporting Statement A Uploaded 2023-10-13 Missing upstream
SEALS PIA Final.pdf Supplementary Document Uploaded 2019-11-18 Repair queued
SEALS IRB Determination.pdf Supplementary Document Uploaded 2023-10-13 Repair queued
2c. Sample Reports.xlsx Supplementary Document Uploaded 2023-10-13 Repair queued
1_Legislation.pdf Supplementary Document Uploaded 2023-10-13 Repair queued
3 SEALS 60dy published FRN.pdf Supplementary Document Uploaded 2023-10-13 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
238600 Program Administration -Child Aggregate Screens (SSP Local Administrator) Form and Instruction Modified
238599 Program Administration - Program Options and Cost Options (SSP Local Administrator) Form and Instruction Modified
238598 SEALS Administration - Add User/Program/School (SSP Local Administrator) Form and Instruction Modified
238597 Add Program and Add User - State Sealant Administrator Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
3,582 0
1,388 0
0 0





table that charts list of burden
  Total Request 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 3,582 0 0 3,582 0 0
Annual Time Burden (Hours) 1,388 0 0 1,388 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No