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Questionnaires for State Epidemiologists Reporting Q Fever (Coxiella burnetii) and for the State Laboratories Testing for Q Fever
Questionnaires for State Epidemiologists Reporting Q Fever (Coxiella burnetii) and for the State Laboratories Testing for Q Fever
OMB: 0920-0529
IC ID: 6977
OMB.report
HHS/CDC
OMB 0920-0529
ICR 200110-0920-001
IC 6977
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
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IC Title:
Questionnaires for State Epidemiologists Reporting Q Fever (Coxiella burnetii) and for the State Laboratories Testing for Q Fever
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
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
90 %
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
100
0
100
0
0
0
Annual IC Time Burden (Hours)
63
0
63
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.