Information Collection

[CSELS/DLS]CDC OneLab Network Formative Evaluation

IC 263194 under ICR 202507-0920-001 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1154-24AR [CSELS/DLS]CDC OneLab Network Formative Evaluation	Form and Instruction
Form 0920-1154-24AR 04_Attachment 1_OneLab Network Survey_10-26-2023 [CSELS/DLS]CDC OneLab Network Formative Evaluation	Form and Instruction
0920-1154-24AR 04_Attachment 1_OneLab Network Survey_10-26-2023 04_Attachment 1_OneLab Network Survey_10-26-2023.docx	Form and Instruction
0920-1154-24AR 04_Attachment 1_OneLab Network Survey_10-26-2023 04_Attachment 1_OneLab Network Survey_10-26-2023.docx	Form and Instruction
01_Formative Research_GenIC_Request_CDC OneLab Network Evaluation_10-26-23.docx Request for Approval	IC Document
01_Formative Research_GenIC_Request_CDC OneLab Network Evaluation_10-26-23.docx Request for Approval	IC Document
02_Supporting Statement A_OneLab Network_10-26-23.docx SSA	IC Document
02_Supporting Statement A_OneLab Network_10-26-23.docx SSA	IC Document
03_Supporting Statement B_OneLab Network Social Network Survey10-26-2023.docx SSB	IC Document
03_Supporting Statement B_OneLab Network Social Network Survey10-26-2023.docx SSB	IC Document
05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023.docx 05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023	IC Document
05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023.docx 05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023	IC Document
06_Attachment 3_OneLab Network OnePager_05102023.pdf 06_Attachment 3_OneLab Network OnePager_05102023	IC Document
06_Attachment 3_OneLab Network OnePager_05102023.pdf 06_Attachment 3_OneLab Network OnePager_05102023	IC Document
07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network.pdf 07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network	IC Document
07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network.pdf 07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[CSELS/DLS]CDC OneLab Network Formative Evaluation

Agency IC Tracking Number:

0920-1154-24AR

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1154-24AR				Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval		11/03/2023
SSA		11/03/2023
SSB		11/03/2023
05_Attachment 2_Invitation and emails to participants_OneLab Network Surveys_10-26-2023		11/03/2023
06_Attachment 3_OneLab Network OnePager_05102023		11/03/2023
07_Attachment 4_Project Determination_Human Subject Research Determination_OneLab Network		11/03/2023

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

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