Information Collection

National Surveillance Of Dialysis-associated Diseases

IC 110627 under ICR 199209-0920-003 · OMB 0920-0033.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0033 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	NATIONAL SURVEILLANCE OF DIALYSIS-ASSOCIATED DISEASES	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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	CDC 53.7				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,250	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,250	450	1,800
Annual IC Time Burden (Hours)	1,313	263	1,050
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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