Evaluation data for private-sector organizations

[NCCDPHP] CDC Diabetes Prevention Recognition Program (DPRP)

Documents and Forms

Document Name Document Type
Form 0920-0909 Evaluation data for private-sector organizations Form and Instruction
Form 0920-0909 Evaluation data for private-sector organizations Form and Instruction
0920-0909 Evaluation Data Form Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx Form and Instruction
0920-0909 Evaluation Data Form Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx Form and Instruction
0920-25-0057 Eval Data _ Private Sector Att 4B Evaluation Data for private sector organizations_OMB No. 0920-0909_03-17-25.xlsx Form
0920-25-0057 Eval Data _ Private Sector Att 4B Evaluation Data for private sector organizations_OMB No. 0920-0909_03-17-25.xlsx Form

Information Collection (IC) Details

IC Title:	Evaluation data for private-sector organizations	Agency IC Tracking Number:	0920-25-0057

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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	0920-0909	Evaluation Data Form	Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx	NA	Yes	Yes	Fillable Fileable
Form	0920-25-0057	Eval Data _ Private Sector	Att 4B Evaluation Data for private sector organizations_OMB No. 0920-0909_03-17-25.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,160	Number of Respondents for Small Entity: 870

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,320	2,320
Annual IC Time Burden (Hours)	4,640	4,640
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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