Information Collection

Infrastructure, Prevention, and Promotion Indicators

IC 192393 under ICR 202509-0930-011 · OMB 0930-0285.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form IPP Indicators Infrastructure, Prevention, and Promotion Indicators	Form and Instruction
Form IPP Indicators IPP Indicators Infrastructure, Prevention, and Promotion Indicators	Form and Instruction
IPP Indicators IPP Indicators B_IPP Indicators.docx	Form and Instruction
IPP Indicators IPP Indicators B_IPP Indicators.docx	Form and Instruction
202404 C_CMHS IPP Results Form.docx IPP Form	IC Document
202404 C_CMHS IPP Results Form.docx IPP Form	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	IPP Indicators				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Infrastructure, Prevention, and Promotion Indicators

FR Citation: 75 FR 28264

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	8,000	8,000
Annual IC Time Burden (Hours)	64,000	64,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
IPP Form		10/01/2024

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

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