OMB control number

ATSDR Communication Activities Survey (ACAS)

OMB 0923-0055 · HHS/TSDR.

OMB 0923-0055

The ACAS will be used to ascertain the effectiveness, and to evaluate the differences and consistency, of ATSDR activity delivery and respondent perceptions across sites and over time; determine how effectively ATSDR's site team engages community members; and discover how well ATSDR provides effective, clear and consistent communication and information on how to promote healthy and safe environments and prevent harmful exposures through the activities they implement in communities.

The latest form for ATSDR Communication Activities Survey (ACAS) expires 2020-06-30 and is listed under ICR 201612-0923-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Agency Stakeholders - SMS Text Survey	Form and Instruction
Community Members - SMS Text Survey	Form and Instruction
Agency Stakeholders - ACAS Telephone	Form and Instruction
Agency Stakeholders - ACAS Online	Form and Instruction
Agency Stakeholders - ACAS Hard Copy	Form and Instruction
Agency Stakeholders - ACAS Sign-In Sheet	Form
Community Members - ACAS Telephone	Form and Instruction
Community Members - ACAS Online	Form and Instruction
Community Members - ACAS Hard Copy	Form and Instruction
Community Members - Sign-In Sheet	Form and Instruction
AttI ACAS Research Determination 20161212.pdf	Supplementary Document
AttG Initial Email for Online ACAS Link 20201130.docx	Supplementary Document
AttD Communty Mtng Fact Sheet 20201130.docx	Supplementary Document
AttC ACAS PIA CPO Signed 20200804.pdf	Supplementary Document
AttC 3rd_Party_SSP_ACAS_ISSO_20200610.pdf	Supplementary Document
AttC 3rd_Party_PIA_ACAS 20200610.pdf	Supplementary Document
AttB ACAS 60-day FRN.pdf	Supplementary Document
AttA3 SARA AuthLegsl.pdf	Supplementary Document
AttA2 RCRA AuthLegsl.pdf	Supplementary Document
AttA1 CERCLA AuthLegsl.pdf	Supplementary Document
1 - ACAS List of Attachments 20201130.docx	Supplementary Document
1 - ACAS SSA 20201210.docx	Supporting Statement A
1-SSB-20201130.docx	Supporting Statement B
Agency Stakeholders - SMS Text Survey	Form and Instruction
Community Members - SMS Text Survey	Form and Instruction
Agency Stakeholders - ACAS Telephone	Form and Instruction
Agency Stakeholders - ACAS Online	Form and Instruction
Agency Stakeholders - ACAS Hard Copy	Form and Instruction
Agency Stakeholders - ACAS Sign-In Sheet	Form
Community Members - ACAS Telephone	Form and Instruction
Community Members - ACAS Online	Form and Instruction
Community Members - ACAS Hard Copy	Form and Instruction
Community Members - Sign-In Sheet	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Concluded	Action
202012-0923-001	Reinstatement with change of a previously approved collection	2020-12-14
201612-0923-001	New collection (Request for a new OMB Control Number)	2017-01-05		Approved with change

OMB Details

Community Members - Sign-In Sheet

Federal Enterprise Architecture: Health - Consumer Health and Safety

Information collection instruments
Form	Name	Electronic access	Type
Form NA	ATSDR Public Meeting Sign-In Sheet	NA	Form and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.