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Federal forms, ICRs, and supporting documents

Information Collection Request

[NCCDPHP] National Program of Cancer Registries Program Evaluation Instrument

ICR 202506-0920-012 · OMB 0920-0706 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0706 NPCR PEI Survey 2026_ Electronic Form Modified Repair queued
Form 0920-0706 NPCR - Program Evaluation Instrument (NPCR-PEI) (Online) Form Modified Repair queued
Form 0920-0706 PEI (Paper) Form Modified Available
Form 0920-0706 NPCR - Program Evaluation Instrument (NPCR-PEI) (Paper) Form Modified Repair queued
0920-0706_2026 Privacy-Narrative-Form_08282024.pdf Supplementary Document Uploaded 2025-07-03 Repair queued
0920-0706 Attachment 8_List of 2022-2027 NPCR Funded Awardees-REV_6.24.2025.docx Supplementary Document Uploaded 2025-07-03 Repair queued
0920-0706 Attachment 11_Human subjects non-research determination.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 11_Human subjects non-research determination.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 10_NPCR Program Evaluation Results 2022.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 10_NPCR Program Evaluation Results 2022.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 7_NPCR Program Standards for NOFO DP2202.docx Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 7_NPCR Program Standards for NOFO DP2202.docx Supplementary Document Uploaded 2025-06-23 Available
0920-0706 Attachment 9_Sample Letter (with PEI Instructions) to NPCR Awardees_2024.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 9_Sample Letter (with PEI Instructions) to NPCR Awardees_2024.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 5_Cancer Registries Amendment Act - Public Law 102-515.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 5_Cancer Registries Amendment Act - Public Law 102-515.pdf Supplementary Document Uploaded 2025-06-23 Missing upstream
0920-0706 Attachment 3_Summary of Changes 2026 PEI.docx Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 3_Summary of Changes 2026 PEI.docx Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706_2026 Privacy-Narrative-Form_01022025.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706_2026 Privacy-Narrative-Form_01022025.pdf Supplementary Document Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 3C_PEI 2022-2024 Changes_2021_Final.docx Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 3C_PEI 2022-2024 Changes_2021_Final.docx Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 3D_Draft Sample Letter w Inst_Final.docx Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 3D_Draft Sample Letter w Inst_Final.docx Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 7_0706_IRB Determination.docx.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 7_0706_IRB Determination.docx.pdf Supplementary Document Uploaded 2021-11-29 Missing upstream
0920-0706 Support Statement-B_6.24.2025.docx Supporting Statement B Uploaded 2025-07-03 Repair queued
0920-0706 Support Statement-B.docx Supporting Statement B Uploaded 2025-06-23 Repair queued
0920-0706 Attachment 6_National Results 2018 Survey_Final.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 6_National Results 2018 Survey_Final.pdf Supplementary Document Uploaded 2021-11-29 Available
0920-0706 Attachment 5_ NPCR Program Standards_Final.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 5_ NPCR Program Standards_Final.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 4_List of 2017-2021 NPCR Funded Awardees_Final.docx Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 4_List of 2017-2021 NPCR Funded Awardees_Final.docx Supplementary Document Uploaded 2021-11-29 Available
0920-0706 Attachment 2A_2021-06291 NPCR PEI Published 60-day FRN.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 2A_2021-06291 NPCR PEI Published 60-day FRN.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 1B_Section 301 of the Public Health Service Act_2021_Final.pdf Supplementary Document Uploaded 2021-11-29 Available
0920-0706 Attachment 1B_Section 301 of the Public Health Service Act_2021_Final.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 1A_Cancer Registries Amendment Act - Public Law 102-515_ 2021_Final.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Attachment 1A_Cancer Registries Amendment Act - Public Law 102-515_ 2021_Final.pdf Supplementary Document Uploaded 2021-11-29 Repair queued
0920-0706 Support Statement-A-508 REV_06242025.docx Supporting Statement A Uploaded 2025-07-03 Repair queued
0920-0706 Support Statement-A-508 REV_02052025.docx Supporting Statement A Uploaded 2025-06-23 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
37809 NPCR - Program Evaluation Instrument (NPCR-PEI) (Online) Form ModifiedNPCR PEI Survey 2026_ Electronic
37809 NPCR - Program Evaluation Instrument (NPCR-PEI) (Online) Form Modified
229225 NPCR - Program Evaluation Instrument (NPCR-PEI) (Paper) Form ModifiedPEI (Paper)
229225 NPCR - Program Evaluation Instrument (NPCR-PEI) (Paper) Form Modified
ICR Details
0920-0706 202506-0920-012
Active 202111-0920-019
HHS/CDC 0920-0706
[NCCDPHP] National Program of Cancer Registries Program Evaluation Instrument
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 08/11/2025
Retrieve Notice of Action (NOA) 06/25/2025
  Inventory as of this Action Requested Previously Approved
08/31/2028 36 Months From Approved
33 0 0
132 0 0
0 0 0
This Reinstatement with Change of a previously approved collection request is to reinstate the NPCR-PEI process and update the survey instrument based on feedback from stakeholders and revisions to NPCR Program Standards. CDC requests a three-year clearance for the proposed program evaluation instrument. Content of the NPCR PEI instrument is updated based on feedback from stakeholders and updates to NPCR Program Standards. A determination was made to edit and clarify various questions; some questions were deleted or revised because they were no longer relevant; no new questions were proposed based on the need for information from awardees to CSB and FOA DP22-2202 requirements.
PL: Pub.L. 102 - 515 3312 Name of Law: Cancer Registries Amendment Act
   US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  89 FR 84145 10/21/2024
90 FR 24622 06/11/2025
No
  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 33 0 0 33 0 0
Annual Time Burden (Hours) 132 0 0 132 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a reinstatement with changes for a proposed annual burden of 132 hours.
$61,825
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 [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.
06/25/2025