OMB control number
DELTA Impact Recipient Monitoring and Assessment Tools
OMB 0920-1247 ยท HHS/CDC.
OMB 0920-1247
Collect information from recipients related to implementation and performance monitoring of cooperative agreement CDC-RFA-CE18-1801: Domestic Violence Prevention Enhancement and Leadership Through Alliances (DELTA) Impact. Information to be collected will provide crucial data for performance monitoring, implementation of prevention strategies, and budget tracking.
The latest form for DELTA Impact Recipient Monitoring and Assessment Tools expires 2021-11-30 and is listed under ICR 202006-0920-013.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 0920-1247 Annual Progress Report Tool | Form and Instruction |
| Crosswalk of APR Changes May 14 new format.docx | Supplementary Document |
| OMB_Change_Request_DELTA_051520 updated 6_8.docx | Justification for No Material/Nonsubstantive Change |
 Att. 7. IRB - Research Determination DELTA Impact.pdf | Supplementary Document |
| Att. 6. Privacy Act applicability.pdf | Supplementary Document |
| Att. 5.FRN 60 Dy 0920-18FO DELTA IMPACT.pdf | Supplementary Document |
| Att. 4 Crosswalk of Evaluation Questions.docx | Supplementary Document |
| Att. 3a. Screenshots APR Tool.docx | Supplementary Document |
| Att. 2. List of Grantees.docx | Supplementary Document |
| Att. 1 Authorizing Legislation FVPSA-DELTA Impact.pdf | Supplementary Document |
| SSB 19FO _ DELTA Impact 8.14.18.docx | Supporting Statement B |
| SSA 19FO _ DELTA Impact 9.15.18_ICRO.docx | Supporting Statement A |
 Annual Progress Report Tool |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202006-0920-013 | No material or nonsubstantive change to a currently approved collection | 2020-06-19 | Approved without change | |
| 201809-0920-001 | New collection (Request for a new OMB Control Number) | 2018-10-11 | Approved without change |