OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Monitoring and Reporting System for the State Public Health Actions Cooperative Agreements

ICR 201411-0920-001 · OMB 0920-1059 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Enhanced Awardees Annual Evaluation Plan Form New Repair queued
Enhanced Awardees Annual Budget Form New Available
Enhanced Awardees Annual Workplan Form New Available
Enhanced Awardees Initial Evaluation Form New Available
Enhanced Awardees Initial Budget Form New Available
Enhanced Awardees Initial Workplan Form New Repair queued
Basic Awardees Annual Evaluation Plan Form New Available
Basic Awardees Annual Budget Form New Available
Basic Awardees Annual Work Plan Form New Available
Basic Awardees Initial Evaluation Plan Form New Repair queued
Basic Awardees Initial Budget Form New Available
Basic Awardees Initial Work Plan Form New Available
Att 1c. PHSA_Research and Investigation.doc Supplementary Document Uploaded 2014-11-03 Available
Att 1a. PHSA_Preventive Health Services.pdf Supplementary Document Uploaded 2014-11-03 Available
Att 1b. ACA_PPHF.pdf Supplementary Document Uploaded 2014-11-03 Available
Att 4e. Screen Shots of FTP Site.docx Supplementary Document Uploaded 2014-11-03 Available
Att 3b. Summary of Public Comments.doc Supplementary Document Uploaded 2014-11-03 Available
Att 3a. 60-day FRN 11 25 2013.pdf Supplementary Document Uploaded 2014-11-03 Repair queued
Att 2. List of awardees.docx Supplementary Document Uploaded 2014-11-03 Available
SS Part B_10 29 2014.docx Supporting Statement B Uploaded 2014-11-03 Available
SS Part A_10 29 2014.docx Supporting Statement A Uploaded 2014-11-03 Available
IC Document Collections
IC IDCollectionTypeStatusForm
213721 Enhanced Awardees Annual Evaluation Plan Form New
213720 Enhanced Awardees Annual Budget Form New
213718 Enhanced Awardees Annual Workplan Form New
213717 Enhanced Awardees Initial Evaluation Form New
213716 Enhanced Awardees Initial Budget Form New
213715 Enhanced Awardees Initial Workplan Form New
213714 Basic Awardees Annual Evaluation Plan Form New
213713 Basic Awardees Annual Budget Form New
213712 Basic Awardees Annual Work Plan Form New
213711 Basic Awardees Initial Evaluation Plan Form New
213710 Basic Awardees Initial Budget Form New
213709 Basic Awardees Initial Work Plan Form New
ICR Details
0920-1059 201411-0920-001
Historical Active
HHS/CDC 14CP
Monitoring and Reporting System for the State Public Health Actions Cooperative Agreements
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 03/26/2015
Retrieve Notice of Action (NOA) 11/14/2014
  Inventory as of this Action Requested Previously Approved
03/31/2018 36 Months From Approved
204 0 0
665 0 0
0 0 0
CDC requests OMB approval for three years to collect performance monitoring and evaluation information from grantees funded through the new State Public Health Actions program.
US Code: 42 USC 247b Name of Law: PHSA
   US Code: 42 USC 241 Name of Law: PHSA
   PL: Pub.L. 111 - 148 4002 Name of Law: ACA
  
None
Not associated with rulemaking
  78 FR 70300 11/25/2013
79 FR 65972 11/06/2014
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 204 0 0 204 0 0
Annual Time Burden (Hours) 665 0 0 665 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.
$229,659
Yes Part B of Supporting Statement
No
Yes
No
No
Uncollected
Shari Steinberg 404 639-4942 [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.
11/14/2014