Information Collection

Requested Amendment to OMB-Approved Project: Best Practices for COVID-19 Vaccination and Testing

IC 265639 under ICR 202403-0990-009 · OMB 0990-0421.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Human Services and Environmental and Climate Justice - Considering Community Concerns and Program Options_OMB Amendment Submissi	Other-Amendment
Human Services and Environmental and Climate Justice - Considering Community Concerns and Program Options_OMB Amendment Submissi	Other-Amendment
Attachment A_Instruments_post-pilot_tracked.docx	Other-Instrument
Attachment A_Instruments_post-pilot_tracked.docx	Other-Instrument
Attachment B_Outreach and Recruitment materials_post-pilot_tracked.docx	Other-outreach materials
Attachment B_Outreach and Recruitment materials_post-pilot_tracked.docx	Other-outreach materials
A_SiteVisits_ASPE_Generic_COVID_SS-A_post-pilot_tracked.docx	Other-post-pilot
A_SiteVisits_ASPE_Generic_COVID_SS-A_post-pilot_tracked.docx	Other-post-pilot
Human Services and Environmental and Climate Justice - Considering Community Concerns and Program Options_OMB Amendment Submission.docx Requested Amendment to OMB-Approved Project: “Human Services and Environmental and Climate Justice: Considering Community Concer	IC Document
Human Services and Environmental and Climate Justice - Considering Community Concerns and Program Options_OMB Amendment Submission.docx Requested Amendment to OMB-Approved Project: “Human Services and Environmental and Climate Justice: Considering Community Concer	IC Document
A_SiteVisits_ASPE_Generic_COVID_SS-A_post-pilot_tracked.docx Site Visit SSA	IC Document
A_SiteVisits_ASPE_Generic_COVID_SS-A_post-pilot_tracked.docx Site Visit SSA	IC Document
Memo to OMB_summary and justification_Non substantive change.docx Memo	IC Document
Memo to OMB_summary and justification_Non substantive change.docx Memo	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Requested Amendment to OMB-Approved Project: Best Practices for COVID-19 Vaccination and Testing

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Amendment	Human Services and Environmental and Climate Justice - Considering Community Concerns and Program Options_OMB Amendment Submission.docx	No	Paper Only
Other-Instrument	Attachment A_Instruments_post-pilot_tracked.docx	No	Paper Only
Other-outreach materials	Attachment B_Outreach and Recruitment materials_post-pilot_tracked.docx	No	Printable Only
Other-post-pilot	A_SiteVisits_ASPE_Generic_COVID_SS-A_post-pilot_tracked.docx	No	Paper Only

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: 57

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	57	-33	90
Annual IC Time Burden (Hours)	14	-66	80
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Requested Amendment to OMB-Approved Project: âHuman Services and Environmental and Climate Justice: Considering Community Concerns and Program Optionsâ	Human Services and Environmental and Climate Justice - Considering Community Concerns and Program Options_OMB Amendment Submission.docx	02/27/2024
Site Visit SSA	A_SiteVisits_ASPE_Generic_COVID_SS-A_post-pilot_tracked.docx	03/27/2024
Memo	Memo to OMB_summary and justification_Non substantive change.docx	03/27/2024

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