[NCIPC] Performance Monitoring of CDC’s Core State Injury Prevention Program

ICR 202506-0920-017

OMB: 0920-1369

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2025-07-23
Supplementary Document
2025-07-23
Supplementary Document
2025-06-25
Supplementary Document
2025-06-25
Supplementary Document
2021-12-22
Supplementary Document
2021-12-22
Supplementary Document
2021-12-22
Supporting Statement B
2025-06-25
Supporting Statement A
2025-06-25
IC Document Collections
IC ID
Document
Title
Status
250897 Modified
ICR Details
0920-1369 202506-0920-017
Received in OIRA 202111-0920-014
HHS/CDC 0920-1369
[NCIPC] Performance Monitoring of CDC’s Core State Injury Prevention Program
Revision of a currently approved collection   No
Regular 07/23/2025
  Requested Previously Approved
36 Months From Approved 09/30/2025
26 23
286 253
0 0

The goal of this ICR is to collect performance monitoring data via a web-based Partners’ Portal. This data is needed to monitor the cooperative agreement program funded under the Core State Injury Prevention Program (Core SIPP recipients of CE21-2101). Data collected will be used to monitor progress toward program goals, identify technical assistance needs of recipients, and to provide accountability for funding to the Department of Health and Human Services (HHS), the White House, Congress, and other sources, upon request. This revision request is to add three recipients to the data collection.

None
None

Not associated with rulemaking

  89 FR 95794 12/30/2024
90 FR 30644 07/10/2025
Yes

1
IC Title Form No. Form Name
Annual Progress Report 0920-1369 Core SIPP Program Annual Progress Report

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 26 23 0 3 0 0
Annual Time Burden (Hours) 286 253 0 33 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This revision is for 286 burden hours and three years of approval. The estimated change in burden from the last OMB approval is 33 hours.

$248,471
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/23/2025


© 2025 OMB.report | Privacy Policy