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Federal forms, ICRs, and supporting documents

Information Collection Request

National Center for Health Statistics Confidentiality Pledge Revision Notice

ICR 201701-0920-006 · OMB 0920-1157 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
NCHS Confidentiality Pledge Revision Notice.docx Supplementary Document Uploaded 2017-01-12 Available
NCHS Statistical Confidentiality Pledge.docx Supplementary Document Uploaded 2017-01-12 Available
NCHS Director Memo for Emergency Clearance to Dmancini.pdf Supplementary Document Uploaded 2017-01-12 Available
Sup Statement NCHS Emergency Clearance Jan11_2017.docx Supporting Statement A Uploaded 2017-01-12 Available
IC Document Collections
IC IDCollectionTypeStatusForm
225156 NCHS Confidentiality Pledge Other-confidentilaity pledge New
ICR Details
0920-1157 201701-0920-006
Historical Active
HHS/CDC 17LN
National Center for Health Statistics Confidentiality Pledge Revision Notice
New collection (Request for a new OMB Control Number)   No
Emergency 01/13/2017
Approved without change 01/23/2017
Retrieve Notice of Action (NOA) 01/13/2017
  Inventory as of this Action Requested Previously Approved
07/31/2017 6 Months From Approved
1 0 0
0 0 0
0 0 0
This emergency clearance is being used to obtain Paperwork Reduction Act (PRA) clearance from OMB for the NCHS Information Collections Requests (ICRs) listed in the table below, in order to implement a revised confidentiality pledge that is resulting from mandatory implementation of the Einstein monitoring by the Department of Homeland (DHS) as mandated by the Cybersecurity Act of 2015.
This is an emergency request for a new information collection to allow for the revision of the NCHS Confidentiality Pledge.
None
None
Not associated with rulemaking
No
1
IC Title Form No. Form Name
NCHS Confidentiality Pledge
  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 1 0 0 1 0 0
Annual Time Burden (Hours) 0 0 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
No
No
No
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.
01/13/2017