OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Monitoring and Reporting for the Core State Violence and Injury Prevention Program Cooperative Agreement

ICR 201603-0920-003 · OMB 0920-1120 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Attachment B2_public comment.pdf Supplementary Document Uploaded 2016-07-01 Available
published 30d FRN.pdf Supplementary Document Uploaded 2016-03-04 Available
IRB-NCIPC ResearchDetr_Core_SVIPP_Sign.pdf Supplementary Document Uploaded 2016-03-03 Available
Att B_60 Dy FRN CORE SVIPP.pdf Supplementary Document Uploaded 2016-03-02 Available
Att A_Public Health Service Act.pdf Supplementary Document Uploaded 2016-03-02 Available
SSB_CoreSVIPP_021116.docx Supporting Statement B Uploaded 2016-03-02 Available
Monitoring and Reporting CoreSVIPP_SSA_CoreSVIPP 022916_OMB_6-30.docx Supporting Statement A Uploaded 2016-07-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
220460 2-Enhanced Component -Injury Indicator Other-WORD New
220459 2-Enhanced Component -Evaluation and Performance Managment Plan Other-WORD New
220458 2-Enhanced Component -Annual Progress Report Other-WORD New
220451 2-Enhanced Component -Initial Population-Annual Progress Report Other-WORD New
220446 1-Enhanced Component -Injury Indicator Other-WORD New
220445 1-Enhanced Component -Evaluation and Performance Management Plan Other-WORD New
220444 1-Enhanced Component -Annual Progress Report Other-WORD New
220424 1-Enhanced_Initial Population- Annual Progress Report Other-WORD New
220420 BASE -Injury Indicator Other-WORD New
220415 BASE -Evaluation and Performance Mgmt Plan Other-WORD New
220413 BASE -Annual Progress Report Other-WORD New
220409 BASE -Annual Progress Report -Intial Population Other-WORD New
ICR Details
0920-1120 201603-0920-003
Historical Active
HHS/CDC 16BZ
Monitoring and Reporting for the Core State Violence and Injury Prevention Program Cooperative Agreement
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 07/05/2016
Retrieve Notice of Action (NOA) 03/07/2016
  Inventory as of this Action Requested Previously Approved
07/31/2019 36 Months From Approved
120 0 0
3,120 0 0
0 0 0
Collect information needed to monitor cooperative agreement programs funded under the Core State Violence and Injury Prevention Program (Core SVIPP) (CDC-RFA-CE16-1602). Information to be collected will provide crucial data for program performance monitoring and provide CDC with the capacity to respond to requests from DHHS.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  80 FR 69225 11/09/2015
81 FR 11568 03/04/2016
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 120 0 0 120 0 0
Annual Time Burden (Hours) 3,120 0 0 3,120 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a NEW collection request for a new OMB Control Number
$242,723
Yes Part B of Supporting Statement
No
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.
03/07/2016