Information Collection

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

IC 270561 under ICR 202412-0920-010 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Techincal Guidance [OADPS]OD2A-LOCAL Cooperative Agreement (# CD23-0003)	Form
Form 0920-24IL Reporting Tool [OADPS]OD2A-LOCAL Cooperative Agreement (# CD23-0003)	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
PEO GenIC Request_OD2A-LOCAL.pdf GenIC Request Memo	IC Document
AttC_OD2A-LOCAL_data entry guide.pdf Data entry guide	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				Yes	Yes	Fillable Fileable
Form	0920-24IL				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

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].