OMB control number

Monitoring and Reporting System for the National Tobacco Control Program

OMB 0920-1097 · HHS/CDC.

OMB 0920-1097

CDC will collect work plan and budget information from State-based tobacco control programs. Information will be used to monitor progress toward achievement of program objectives, and to support program improvement.

The latest form for Monitoring and Reporting System for the National Tobacco Control Program expires 2023-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0920-1097 Annual Progress Report template for the National and State Tobacco Control Program Form and Instruction
Form 0920-1097 Annual Component Model of Infrastructure for the National and State Tobacco Control Program Form and Instruction
Form 0920-1097 Annual Performance Measures template for the National and State Tobacco Control Program Form and Instruction
Form 0920-1097 Annual Budget template for the National Tobacco Control Program Form and Instruction
Form 0920-1097 Annual Work Plan template for the National and State Tobacco Control Program Form and Instruction
Annual Budget Progress Report Form
Initial Population of Budget Tool Form
Annual Work Plan Progress Report Form
Initial Population of Work Plan Tool Form
1097 Att 2 Awardees Final.docx Supplementary Document
1097 Att 1c CSTHEA Final.pdf Supplementary Document
1097 Att 1b PL Final.pdf Supplementary Document
1097 Att 1a PHSA Final.pdf Supplementary Document
1097 Att 3b Public Comments Final.docx Supplementary Document
1097 Att 3a_60 day FRN Published Final.pdf Supplementary Document
1097 Privacy Narrative Final.pdf Supplementary Document
Att 3b. Summary of Public Comments.pdf Supplementary Document
Att 3a. FRN 6 05 2015.pdf Supplementary Document
Att 2. Awardees.docx Supplementary Document
1097 SSB FINAL.docx Supporting Statement B
1097 SSA FINAL.docx Supporting Statement A
Att 1c. CSTHEA.pdf Supplementary Document
Att 1b. PL 98-474 07-15-2014.pdf Supplementary Document
Att 1a. PHSA 07-15-2014.pdf Supplementary Document
Annual Progress Report template for the National and State Tobacco Control Program Form and Instruction
Annual Component Model of Infrastructure for the National and State Tobacco Control Program Form and Instruction
Annual Performance Measures template for the National and State Tobacco Control Program Form and Instruction
Annual Budget template for the National Tobacco Control Program Form and Instruction
Annual Work Plan template for the National and State Tobacco Control Program Form and Instruction
Annual Budget Progress Report Form
Initial Population of Budget Tool Form
Annual Work Plan Progress Report Form
Initial Population of Work Plan Tool Form

All Historical Document Collections

201912-0920-010 Approved without change	Reinstatement with change of a previously approved collection	2020-02-05
201508-0920-002 Approved without change	New collection (Request for a new OMB Control Number)	2015-08-19

OMB Details

Initial Population of Work Plan Tool

Federal Enterprise Architecture: Health - Public Health Monitoring

Form none

National Tobacco Control Programs Work Plan Template

Fillable Fileable

Form

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.