Information Collection Request

National Quitline Data Warehouse

ICR 201105-0920-009 · OMB 0920-0856 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Quitline Services Questionnaire Form Modified Repair queued
Follow-up for Callers who Received a Quitline Service Form Modified Available
Intake Information for Callers who Contact the Quitline for Personal Use Form Modified Repair queued
Intake Information for Callers who Contact the Quitline for Someone Else Form Modified Available
0920-0856 Change Request Justification_05 13 2011.docx Justification for No Material/Nonsubstantive Change Uploaded 2011-05-16 Available
G3. Reminder Email for Services Questionnaire.docx Supplementary Document Uploaded 2010-05-17 Repair queued
G2. Advance Email for Services Questionnaire.docx Supplementary Document Uploaded 2010-05-17 Repair queued
F2. NQDW Advance Letter for Folllow-up.doc Supplementary Document Uploaded 2010-05-17 Available
ICR Details
0920-0856 201105-0920-009
Historical Active 201006-0920-002
HHS/CDC
National Quitline Data Warehouse
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 05/23/2011
Retrieve Notice of Action (NOA) 05/18/2011
  Inventory as of this Action Requested Previously Approved
07/31/2012 07/31/2012 07/31/2012
759,112 0 759,112
90,563 0 90,563
0 0 0

CDC will collect newly standardized information from Quitline service providers in 50 states, DC, Puerto Rico and Guam. Data about each program will be collected, as well as caller intake and follow-up data. Information will be used for program improvement and to evaluate the expenditure of funding provided by the ARRA of 2009.

US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 5 1 Name of Law: American Recovery and Reinvestment Act of 2009
  
None

Not associated with rulemaking

Yes

  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 759,112 759,112 0 0 0 0
Annual Time Burden (Hours) 90,563 90,563 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$3,125,962
Yes Part B of Supporting Statement
Yes
No
No
Yes
Uncollected
Daniel Holcomb 770 488-4472 [email protected]

  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.
05/18/2011