OMB control number

Monitoring and Reporting System for the State Public Health Actions Cooperative Agreements

OMB 0920-1059 · HHS/CDC.

OMB 0920-1059

Latest forms, documents, and information collections
Document	Type
Enhanced Awardees Annual Evaluation Plan	Form
Enhanced Awardees Annual Budget	Form
Enhanced Awardees Annual Workplan	Form
Enhanced Awardees Initial Evaluation	Form
Enhanced Awardees Initial Budget	Form
Enhanced Awardees Initial Workplan	Form
Basic Awardees Annual Evaluation Plan	Form
Basic Awardees Annual Budget	Form
Basic Awardees Annual Work Plan	Form
Basic Awardees Initial Evaluation Plan	Form
Basic Awardees Initial Budget	Form
Basic Awardees Initial Work Plan	Form
Att 1c. PHSA_Research and Investigation.doc	Supplementary Document
Att 1a. PHSA_Preventive Health Services.pdf	Supplementary Document
Att 1b. ACA_PPHF.pdf	Supplementary Document
Att 4e. Screen Shots of FTP Site.docx	Supplementary Document
Att 3b. Summary of Public Comments.doc	Supplementary Document
Att 3a. 60-day FRN 11 25 2013.pdf	Supplementary Document
Att 2. List of awardees.docx	Supplementary Document
SS Part B_10 29 2014.docx	Supporting Statement B
SS Part A_10 29 2014.docx	Supporting Statement A
Enhanced Awardees Annual Evaluation Plan	Form
Enhanced Awardees Annual Budget	Form
Enhanced Awardees Annual Workplan	Form
Enhanced Awardees Initial Evaluation	Form
Enhanced Awardees Initial Budget	Form
Enhanced Awardees Initial Workplan	Form
Basic Awardees Annual Evaluation Plan	Form
Basic Awardees Annual Budget	Form
Basic Awardees Annual Work Plan	Form
Basic Awardees Initial Evaluation Plan	Form
Basic Awardees Initial Budget	Form
Basic Awardees Initial Work Plan	Form

Historical document collections
Reference	Filing	Received	Concluded	Action
201411-0920-001	New collection (Request for a new OMB Control Number)	2014-11-14		Approved without change