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Investigation Protocol Template
[NCIPC] Public Health/Public Safety Strategies to Reduce Drug Overdose Data Collection
OMB: 0920-1419
IC ID: 261657
OMB.report
HHS/CDC
OMB 0920-1419
ICR 202408-0920-013
IC 261657
( )
Documents and Forms
Document Name
Document Type
Form 0920-
Investigation Protocol Template
Form and Instruction
Form 0920-
Investigation Protocol Template
Form and Instruction
0920- Investigation Protocol Template
Attachment C Request Protocol_PHPS GenIC_v3.docx
Form and Instruction
0920- Investigation Protocol Template
Attachment C Request Protocol_PHPS GenIC_v3.docx
Form and Instruction
Attachment D Burden memo PHPS GenIC_v3.docx
Burden Memo
IC Document
Attachment D Burden memo PHPS GenIC_v3.docx
Burden Memo
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Investigation Protocol Template
Agency IC Tracking Number:
0920-23FQ
IC Status:
Unchanged
Obligation to Respond:
Mandatory
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-
Investigation Protocol Template
Attachment C Request Protocol_PHPS GenIC_v3.docx
Yes
Yes
Fillable Fileable
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:
5,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
Requested
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
5,000
0
0
0
0
5,000
Annual IC Time Burden (Hours)
2,500
0
0
0
0
2,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Burden Memo
Attachment D Burden memo PHPS GenIC_v3.docx
09/05/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.