OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

An Assessment of the State Public Health Actions (“1305”) Program

OMB 0920-1152 · HHS/CDC.

OMB 0920-1152

Latest Forms, Documents, and Supporting Material

Document Name
State Synergy Survey Form
Att 7_IRB Approval Letter_5-6-16.PDF Supplementary Document
Att 6c_Reminder Email Template_5-6-16.docx Supplementary Document
Att 6b_Participant Email Template_5-6-16.docx Supplementary Document
Att 6a_Advance Notice Blast Email Template_5-6-16.docx Supplementary Document
Att 4_Evaluation Questions, Indicators, and Synergy Survey Topics_5-23-16.docx Supplementary Document
Att 3_State Public Health Actions 1305 Logic Model_5-5-16.docx Supplementary Document
Att 2b_public comment 05032016.pdf Supplementary Document
Att 2a_Federal Register Notice.pdf Supplementary Document
Att 1_Authorizing Legislation PHSA.doc Supplementary Document
Part B_16RZ_5-26-16.docx Supporting Statement B
Part A_16RZ_6-13-2016.docx Supporting Statement A
State Synergy Survey Form

All Historical Document Collections

201606-0920-013

Approved without change

New collection (Request for a new OMB Control Number)

2016-06-27