OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluation of the C. Everett Koop Community Health Information Center (CHIC)

ICR 199811-0920-002 · OMB 0920-0439 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
6857 Evaluation of the C. Everett Koop Community Health Information Center (CHIC) Migrated
ICR Details
0920-0439 199811-0920-002
Historical Active
HHS/CDC
Evaluation of the C. Everett Koop Community Health Information Center (CHIC)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/07/1999
Retrieve Notice of Action (NOA) 11/09/1998
This collection is approved on the condition that CDC add the burden disclosure statement in accordance with the Paperwork Reduction Act of 1995.
  Inventory as of this Action Requested Previously Approved
11/30/1999 11/30/1999
75 0 0
17 0 0
0 0 0
The proposed data collection will obtain information to evaluate the satisfaction of paying patrons who use the C. Everett Koop Community Health Information Center (CHIC) in Philadelphia, PA, and to survey nonusers who represent key intermediary organizations that work with intended users of the CHIC.
None
None
No
1
IC Title Form No. Form Name
Evaluation of the C. Everett Koop Community Health Information Center (CHIC)
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 75 0 0 75 0 0
Annual Time Burden (Hours) 17 0 0 17 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/09/1998