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 is listed under ICR 202603-0920-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
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	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All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202603-0920-001	Extension without change of a currently approved collection	2026-03-24
202204-0920-006	New collection (Request for a new OMB Control Number)	2022-08-19		Approved without change