Information Collection

0920-0573 - HIV Incidence Surveillance Data Elements and Procedures

IC 46033 under ICR 200611-0920-001 · OMB 0920-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:

Documents and Forms

Document Name Document Type
Attachment F Incidence.pdf Instruction
CDC 50.42A Adult HIV/AIDS Confidential Case Report Attachment C adult crf.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	0920-0573 - HIV Incidence Surveillance Data Elements and Procedures	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Instruction			Attachment F Incidence.pdf		Yes	Yes	Fillable Printable
Form	CDC 50.42A	Adult HIV/AIDS Confidential Case Report	Attachment C adult crf.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	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 Agency Discretion
Annual Number of Responses for this IC	84,990	84,990
Annual IC Time Burden (Hours)	14,165	14,165
Annual IC Cost Burden (Dollars)	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.