NIEHS Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (Federal)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NIEHS Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (Federal) Form
1 PEPH Aware-Act-Use Survey PEPH_Aware-Act-Use_Survey_Final_06-20-2018v3.docx Form
1 PEPH Aware-Act-Use Survey PEPH_Aware-Act-Use_Survey_Final_06-20-2018v3.docx Form
Fast Track _PEPH Federal Government.docx PEPH Federal Government IC Document
Fast Track _PEPH Federal Government.docx PEPH Federal Government IC Document

Information Collection (IC) Details

IC Title:	NIEHS Partnerships for Environmental Public Health (PEPH) Aware-Act-Use (Federal)	Agency IC Tracking Number:

IC Status: Unchanged

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	1	PEPH Aware-Act-Use Survey	PEPH_Aware-Act-Use_Survey_Final_06-20-2018v3.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 238	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	238	238
Annual IC Time Burden (Hours)	20	20
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PEPH Federal Government	Fast Track _PEPH Federal Government.docx	06/21/2018

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