OMB control number

[NCCDPHP] Evaluation Reporting Template for the National and State Tobacco Control Program

OMB 0920-1390 · HHS/CDC.

OMB 0920-1390

The purpose of this request is to evaluate the National Center for Chronic Disease Prevention and Health Promotion cooperative agreement CDC-RFA-DP20-2001: National and State Tobacco Control Program. Information will be used for measuring the progress made by National and State Tobacco Control programs and to respond to inquiries from the Department of Health and Human Services (HHS), the U.S. Congress, and other sources about outcomes of funding. This is an Extension ICR submitted to request an additional three-year approval period.

The latest form for [NCCDPHP] Evaluation Reporting Template for the National and State Tobacco Control Program expires 2029-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1390 Annual Evaluation Reporting Guidance and Template for CDC-RFA-DP20-2001: National and State Tobacco Control Program _24MAR2026 Form and Instruction
NTCP Report Template Form and Instruction
0920-1390 -Supporting Statement A.docx Supporting Statement A
0920-1390 Tobacco Supporting Statement B.docx (document unavailable) Supporting Statement B
Att 3b - Public Comment - Coalition on CDC National and State Tobacco Control Program_12_01_2025.pdf Public Comments
0920-1390 60 day FRN 9-30-2025.pdf Supplementary Document
Att 4 Research Determination_20220324.pdf Supplementary Document
Att 3 CDC-2021-0108-0001_Published 60 Day FRN.pdf Supplementary Document
Att 1c CSTHEA.pdf Supplementary Document
Att 1b PL.pdf Supplementary Document
Att 1a PHSA.pdf Supplementary Document
Evaluation Report for National and State Tobacco Control Program Form and Instruction
Evaluation Report for National and State Tobacco Control Program Form and Instruction
Evaluation Report for National and State Tobacco Control Program Form and Instruction

All Historical Document Collections

202603-0920-001	Extension without change of a currently approved collection	2026-03-24
202204-0920-006 Approved without change	New collection (Request for a new OMB Control Number)	2022-08-19