Information Collection Request

[NCCDPHP] Maternal Mortality Review Information Application (MMRIA)

ICR 202304-0920-003 · OMB 0920-1294 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1294 can be found here:

Forms and Documents

Document Name	Status
Data Abstraction Second Funding Support Form and Instruction	New
Committee Decision Form and Instruction	Modified
Data Abstraction Form and Instruction	Modified
Attachment 8. List of changes to MMRIA forms .docx Supplementary Document	2023-04-14
Attachment 7. MMRIA Request for Determination of Research Status.pdf Supplementary Document	2023-04-14
Attachment 6. MMRIA Memorandum of Understanding for Central Hosting of MMRIA.docx Supplementary Document	2023-04-14
Attachment 5. Privacy Impact Assessment.pdf Supplementary Document	2023-04-14
Attachment 4b. Response to Public Comments on the 60-Day Federal Register Notice.docx Supplementary Document	2023-04-14
Attachment 4a. MMRIA 60-Day Federal Register Notice.pdf Supplementary Document	2023-04-14
Attachment 2. Data Flow Diagram.pdf Supplementary Document	2023-04-14
Attachment 1b. Preventing Maternal Deaths Act.pdf Supplementary Document	2023-04-14
Attachment 1a. Section 301 of the Public Health Service Act (42 U.S.C. 241).docx Supplementary Document	2019-12-19
MMRIA SSB_30 day_3_30_2023.docx Supporting Statement B	2023-04-14
MMRIA SSA_30 day_3_30_2023_final.docx Supporting Statement A	2023-04-17

IC Document Collections

IC ID	Document Title	Status
259715	Data Abstraction Second Funding Support Form and Instruction	New
239003	Committee Decision Form and Instruction	Modified
238999	Data Abstraction Form and Instruction	Modified

ICR Details

Status	Received in OIRA
Agency/Subagency	HHS/CDC
OMB Control No	0920-1294
Type of Information Collection	Revision of a currently approved collection
Previous ICR Reference No	201912-0920-002
Agency Tracking No	0920-1294
Date Submitted to OIRA	1969-12-31
Requested Expiration Date	1969-12-31