Information Collection

CRCCP Quarterly Program Update

IC 244537 under ICR 202404-0920-011 · OMB 0920-1074.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1074 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1074 CRCCP Quarterly Program Update Form
0920-1074 CRCCP Quarterly Program Update Attachment 6a - CRCCP Quarterly Program Update (screenshots).docx Form
0920-1074 CRCCP Quarterly Program Update Attachment 6a - CRCCP Quarterly Program Update (screenshots).docx Form
Attachment 6b - CRCCP Quarterly Program Update Pre-Administration Email.docx Attachment 6b - CRCCP Quarterly Program Update Pre-Administration Email IC Document
Attachment 6b - CRCCP Quarterly Program Update Pre-Administration Email.docx Attachment 6b - CRCCP Quarterly Program Update Pre-Administration Email IC Document
Attachment 6c - CRCCP Quarterly Program Update Administration Email.docx Attachment 6c - CRCCP Quarterly Program Update Administration Email IC Document
Attachment 6c - CRCCP Quarterly Program Update Administration Email.docx Attachment 6c - CRCCP Quarterly Program Update Administration Email IC Document
Attachment 6d - CRCCP Quarterly Program Update Reminder Email.docx Attachment 6d - CRCCP Quarterly Program Update Reminder Email IC Document
Attachment 6d - CRCCP Quarterly Program Update Reminder Email.docx Attachment 6d - CRCCP Quarterly Program Update Reminder Email IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CRCCP Quarterly Program Update	Agency IC Tracking Number:	0920-1074

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	0920-1074	CRCCP Quarterly Program Update	Attachment 6a - CRCCP Quarterly Program Update (screenshots).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	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 Agency Discretion
Annual Number of Responses for this IC	140	140
Annual IC Time Burden (Hours)	51	51
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 6b - CRCCP Quarterly Program Update Pre-Administration Email	Attachment 6b - CRCCP Quarterly Program Update Pre-Administration Email.docx	05/07/2024
Attachment 6c - CRCCP Quarterly Program Update Administration Email	Attachment 6c - CRCCP Quarterly Program Update Administration Email.docx	05/07/2024
Attachment 6d - CRCCP Quarterly Program Update Reminder Email	Attachment 6d - CRCCP Quarterly Program Update Reminder Email.docx	05/07/2024

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