Evaluation data for public-sector organizations

[NCCDPHP] CDC Diabetes Prevention Recognition Program (DPRP)

Documents and Forms

Document Name Document Type
Form 0920-0909 Evaluation data for public-sector organizations Form and Instruction
0920-0909 Evaluation Data Form Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx Form and Instruction
0920-0909 Evaluation Data Form Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx Form and Instruction

Information Collection (IC) Details

IC Title:	Evaluation data for public-sector organizations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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	0920-0909	Evaluation Data Form	Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 740	Number of Respondents for Small Entity: 555

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,480	220	1,260
Annual IC Time Burden (Hours)	2,960	440	2,520
Annual IC Cost Burden (Dollars)	0	0	0

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.