OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Identifying customers' pain points and opportunities to collect, manage, and use data to inform the design of shared services between CDC and state, territorial, and local ph authoriities

IC 258374 under ICR 202505-0920-006 · OMB 0920-1050.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Identifying customers' pain points and opportunities to collect, manage, and use data to inform the design of shared services between CDC and state, territorial, and local ph authoriities 0920-1050-23CN
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Attachment A - CDCF PRA request_final.docx Yes Yes Fillable Fileable
Form and Instruction n/a Question Pool for CDC Foundation Attachment B Questions for CDC-F.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

300 0
   
State, Local, and Tribal Governments
 
   100 %

  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 300 0 0 0 0 300
Annual IC Time Burden (Hours) 300 0 0 0 0 300
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Request Template 0920-1050 Customer Service GenIC Clearance CDCF 013123_final.docx 02/07/2023
OMB Control Header and Burden Statement OMB Information.docx 02/07/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.