Information Collection

[OADPS]OD2A-LOCAL Cooperative Agreement (# CD23-0003)

IC 270561 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-24IL [OADPS]OD2A-LOCAL Cooperative Agreement (# CD23-0003)	Form
0920-24IL Techincal Guidance AttA_OD2A-LOCAL PM Technical Guidance.pdf	Form
0920-24IL Techincal Guidance AttA_OD2A-LOCAL PM Technical Guidance.pdf	Form
0920-24IL Reporting Tool AttB_OD2A-LOCAL_ Excel Reporting Tool.xlsx	Form
0920-24IL Reporting Tool AttB_OD2A-LOCAL_ Excel Reporting Tool.xlsx	Form
PEO GenIC Request_OD2A-LOCAL.pdf GenIC Request Memo	IC Document
PEO GenIC Request_OD2A-LOCAL.pdf GenIC Request Memo	IC Document
AttC_OD2A-LOCAL_data entry guide.pdf Data entry guide	IC Document
AttC_OD2A-LOCAL_data entry guide.pdf Data entry guide	IC Document
OD2A_LOCAL email notification.docx Email Notification	IC Document
OD2A_LOCAL email notification.docx Email Notification	IC Document

IC Title:

[OADPS]OD2A-LOCAL Cooperative Agreement (# CD23-0003)

Agency IC Tracking Number:

0920-24IL

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-24IL	Techincal Guidance	AttA_OD2A-LOCAL PM Technical Guidance.pdf		Yes	Yes	Fillable Fileable
Form	0920-24IL	Reporting Tool	AttB_OD2A-LOCAL_ Excel Reporting Tool.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 80

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	1,400	1,400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC Request Memo	PEO GenIC Request_OD2A-LOCAL.pdf	08/30/2024
Data entry guide	AttC_OD2A-LOCAL_data entry guide.pdf	08/30/2024
Email Notification	OD2A_LOCAL email notification.docx	08/30/2024

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