OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV, Coordinated School Health and Asthma Management for Adolescent and School Health Programs

ICR 201104-0920-008 · OMB 0920-0672 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
SS Part B 033011.doc Supporting Statement B Uploaded 2011-04-01 Available
Att H_Desc of Chgs to Questionnaires.doc Supplementary Document Uploaded 2011-04-01 Repair queued
Att G_Funded partners list.doc Supplementary Document Uploaded 2011-04-01 Repair queued
Attachment B 60-day FRN.pdf Supplementary Document Uploaded 2011-04-01 Available
Attachment A Authorizing Legislation.pdf Supplementary Document Uploaded 2011-04-01 Available
684 Form.pdf Supplementary Document Uploaded 2011-04-01 Repair queued
0920-0672 SupSta A. 1 (FY10-12) 0411.doc Supporting Statement A Uploaded 2011-04-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
7140 Att D - Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007) Other-WORD Modified
184578 Att F - Indicators for School Health Programs: Asthma Management (LEA) Other-WORD Modified
184577 Att E - Indicators for School Health Programs: Coordinated School Health Programs Other-WORD Modified
184576 Indicators for School Health Programs: HIV Prevention (for State Education Agencies) Other-WORD Modified
ICR Details
0920-0672 201104-0920-008
Historical Active 200804-0920-002
HHS/CDC
Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV, Coordinated School Health and Asthma Management for Adolescent and School Health Programs
Revision of a currently approved collection   No
Regular
Approved without change 06/04/2011
Retrieve Notice of Action (NOA) 04/12/2011
  Inventory as of this Action Requested Previously Approved
06/30/2014 36 Months From Approved 06/30/2011
106 0 102
811 0 783
0 0 0
CDC requests OMB clearance for a 3-year continue annual web based collection of Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV Prevention, Coordinated School Health Program, and Asthma Management Activities in local, state, territorial, and tribal education agencies.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  76 FR 1618 01/11/2011
76 FR 19363 04/07/2011
No
  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 106 102 0 0 4 0
Annual Time Burden (Hours) 811 783 0 0 28 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$110,975
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Thelma Sims 4046394771
  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.
04/12/2011