Information Collection

[OADPS] Performance Measures Reporting for OD2A in States Cooperative Agreement

IC 270420 under ICR 202505-0920-010 · 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⚠️ Notice: This information collection may be referencing outdated material.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 0920-1282 OD2A-S Performance Measures Reporting Tool [OADPS] Performance Measures Reporting for OD2A in States Cooperative Agreement	Form and Instruction
AttA_OD2A-STATE_PM Technical Guidance.pdf	Instruction
AttA_OD2A-STATE_PM Technical Guidance.pdf	Instruction
AttC_OD2A-STATE_data entry guide.pdf	Other-Screenshots
AttC_OD2A-STATE_data entry guide.pdf	Other-Screenshots
0920-1282 OD2A-S Performance Measures Reporting Tool AttB_OD2A-STATE_Excel Reporting Tool.xlsx	Form and Instruction
0920-1282 OD2A-S Performance Measures Reporting Tool AttB_OD2A-STATE_Excel Reporting Tool.xlsx	Form and Instruction
PEO GenIC Request _OD2A-STATE.pdf genIC (24IM) Performance Measures Project Request for genIC Approval (for data collection in 2023, 2024, 2025)	IC Document
PEO GenIC Request _OD2A-STATE.pdf genIC (24IM) Performance Measures Project Request for genIC Approval (for data collection in 2023, 2024, 2025)	IC Document
OD2A_STATE email notification.docx OD2A_STATE email notification	IC Document
OD2A_STATE email notification.docx OD2A_STATE email notification	IC Document

IC Title:

[OADPS] Performance Measures Reporting for OD2A in States Cooperative Agreement

Agency IC Tracking Number:

0920-1282-24IM

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction		Yes	No	Printable Only
Form and Instruction	0920-1282	Yes	Yes	Fillable Fileable
Other-Screenshots		No		Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	1,750	1,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
genIC (24IM) Performance Measures Project Request for genIC Approval (for data collection in 2023, 2024, 2025)		08/27/2024
OD2A_STATE email notification		08/28/2024

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

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