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CRCCP Annual Awardee Survey
Colorectal Cancer Control Program (CRCCP) Monitoring Activities
OMB: 0920-1074
IC ID: 217152
OMB.report
HHS/CDC
OMB 0920-1074
ICR 202404-0920-011
IC 217152
( )
Documents and Forms
Document Name
Document Type
Form 0920-1074
CRCCP Annual Awardee Survey
Form
0920-1074 CRCCP Annual Awardee Survey
Attachment 4a - CRCCP Annual Awardee Survey (screenshots).docx
Form
0920-1074 CRCCP Annual Awardee Survey
Attachment 4a - CRCCP Annual Awardee Survey (screenshots).docx
Form
Attachment 4b - CRCCP Survey Introductory Email.docx
Attachment 4b - CRCCP Survey Introductory Email
IC Document
Attachment 4b - CRCCP Survey Introductory Email.docx
Attachment 4b - CRCCP Survey Introductory Email
IC Document
Attachment 4c - CRCCP Survey Reminder Email.docx
Attachment 4c - CRCCP Survey Reminder Email
IC Document
Attachment 4c - CRCCP Survey Reminder Email.docx
Attachment 4c - CRCCP Survey Reminder Email
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CRCCP Annual Awardee Survey
Agency IC Tracking Number:
0920-1074
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
0920-1074
CRCCP Annual Awardee Survey
Attachment 4a - CRCCP Annual Awardee Survey (screenshots).docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
35
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
35
0
35
0
0
0
Annual IC Time Burden (Hours)
9
0
9
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 4b - CRCCP Survey Introductory Email
Attachment 4b - CRCCP Survey Introductory Email.docx
05/07/2024
Attachment 4c - CRCCP Survey Reminder Email
Attachment 4c - CRCCP Survey Reminder Email.docx
05/07/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.