Information Collection

Evaluation data for public-sector organizations

IC 199191 under ICR 202503-0920-024 · OMB 0920-0909.

Documents and Forms

Document Name Document Type
Form 0920-0909 Evaluation data for public-sector organizations Form and Instruction
Form 0920-0909 Evaluation data for public-sector organizations Form and Instruction
0920-0909 Evaluation Data Form Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx Form and Instruction
0920-0909 Evaluation Data Form Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx Form and Instruction
0920-25-0057 Eval Data _ Public Sector Att 4B Evaluation Data for public sector organizations_OMB No. 0920-0909_03-17-25.xlsx Form
0920-25-0057 Eval Data _ Public Sector Att 4B Evaluation Data for public sector organizations_OMB No. 0920-0909_03-17-25.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Evaluation data for public-sector organizations	Agency IC Tracking Number:	0920-25-0057

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0909	Evaluation Data Form	Att 4B Evaluation Data_OMB No. 0920-0909_09-27-23_final.xlsx	NA	Yes	Yes	Fillable Fileable
Form	0920-25-0057	Eval Data _ Public Sector	Att 4B Evaluation Data for public sector organizations_OMB No. 0920-0909_03-17-25.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 740	Number of Respondents for Small Entity: 555

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,480	1,480
Annual IC Time Burden (Hours)	2,960	2,960
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.