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FASD Work Plan
Improving Fetal Alcohol Spectrum Disorders Prevention and Practice through Practice and Implementation Centers and National Partnerships
OMB: 0920-1129
IC ID: 220419
OMB.report
HHS/CDC
OMB 0920-1129
ICR 201707-0920-006
IC 220419
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1129 can be found here:
2021-02-08 - Reinstatement without change of a previously approved collection
Documents and Forms
Document Name
Document Type
FASD Work Plan
Form
FASD Work Plan
I4 Pediatric FASD Regional Education and Awareness Liaisons Work Plan.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
FASD Work Plan
Agency IC Tracking Number:
Is this a Common Form?
No
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
none
FASD Work Plan
I4 Pediatric FASD Regional Education and Awareness Liaisons Work Plan.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
10
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
10
0
0
0
0
10
Annual IC Time Burden (Hours)
3
0
0
0
0
3
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.