Information Collection

[OADPS] Performance Measures Reporting for OD2A in States Cooperative Agreement

IC 270420 under ICR 202411-0920-003 · OMB 0920-1282.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1282 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AttA_OD2A-STATE_PM Technical Guidance.pdf	Instruction
AttA_OD2A-STATE_PM Technical Guidance.pdf	Instruction
AttC_OD2A-STATE_data entry guide.pdf	Other-Screenshots
AttC_OD2A-STATE_data entry guide.pdf	Other-Screenshots
0920-1282 OD2A-S Performance Measures Reporting Tool AttB_OD2A-STATE_Excel Reporting Tool.xlsx	Form and Instruction
0920-1282 OD2A-S Performance Measures Reporting Tool AttB_OD2A-STATE_Excel Reporting Tool.xlsx	Form and Instruction
PEO GenIC Request _OD2A-STATE.pdf genIC (24IM) Performance Measures Project Request for genIC Approval (for data collection in 2023, 2024, 2025)	IC Document
PEO GenIC Request _OD2A-STATE.pdf genIC (24IM) Performance Measures Project Request for genIC Approval (for data collection in 2023, 2024, 2025)	IC Document
OD2A_STATE email notification.docx OD2A_STATE email notification	IC Document
OD2A_STATE email notification.docx OD2A_STATE email notification	IC Document

IC Title:

[OADPS] Performance Measures Reporting for OD2A in States Cooperative Agreement

Agency IC Tracking Number:

0920-1282-24IM

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			AttA_OD2A-STATE_PM Technical Guidance.pdf	Yes	No	Printable Only
Form and Instruction	0920-1282	OD2A-S Performance Measures Reporting Tool	AttB_OD2A-STATE_Excel Reporting Tool.xlsx	Yes	Yes	Fillable Fileable
Other-Screenshots			AttC_OD2A-STATE_data entry guide.pdf	No		Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

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	Previously Approved
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	1,750	1,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
genIC (24IM) Performance Measures Project Request for genIC Approval (for data collection in 2023, 2024, 2025)	PEO GenIC Request _OD2A-STATE.pdf	08/27/2024
OD2A_STATE email notification	OD2A_STATE email notification.docx	08/28/2024

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