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Federal forms, ICRs, and supporting documents

Information Collection

[NCHHSTP] Performance Measurement for STD Prevention (carryover to 2023-2025)

IC 258148 under ICR 202505-0920-010 · OMB 0920-1282.

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Form and Instruction
Form and Instruction
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Information Collection (IC) Details

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[NCHHSTP] Performance Measurement for STD Prevention (carryover to 2023-2025) 0920-20KO
 
Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None STD PCHD Performance Measurement Att 1_Data Collection Tool_02242020.xlsx Yes Yes Fillable Fileable

Health Illness Prevention

 

177 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 177 0 0 0 0 177
Annual IC Time Burden (Hours) 5,310 0 0 0 0 5,310
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Request Template STD Prevention PS19-1901 (carryover 2023-2025) PPEO GenIC Template_PS19-1901_2023-2025.docx 01/30/2023
Notification Email Att 2_Notification Email.v2.docx 01/30/2023
Overview and Logic Model for PS19-1901 STD PCHD Att 3 STD PCHD Overview and Logic Model.pdf 01/30/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.