OMB control number
An Assessment of the State Public Health Actions (“1305”) Program
OMB 0920-1152 · HHS/CDC.
OMB 0920-1152
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 State Synergy Survey | Form |
 Att 7_IRB Approval Letter_5-6-16.PDF | Supplementary Document |
| Att 6c_Reminder Email Template_5-6-16.docx | Supplementary Document |
| Att 6b_Participant Email Template_5-6-16.docx | Supplementary Document |
| Att 6a_Advance Notice Blast Email Template_5-6-16.docx | Supplementary Document |
| Att 4_Evaluation Questions, Indicators, and Synergy Survey Topics_5-23-16.docx | Supplementary Document |
| Att 3_State Public Health Actions 1305 Logic Model_5-5-16.docx | Supplementary Document |
| Att 2b_public comment 05032016.pdf | Supplementary Document |
| Att 2a_Federal Register Notice.pdf | Supplementary Document |
 Att 1_Authorizing Legislation PHSA.doc | Supplementary Document |
| Part B_16RZ_5-26-16.docx | Supporting Statement B |
| Part A_16RZ_6-13-2016.docx | Supporting Statement A |
 State Synergy Survey |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201606-0920-013 | New collection (Request for a new OMB Control Number) | 2016-06-27 | Approved without change |