Information Collection

HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Form EZ

IC 46421 under ICR 200612-0920-004 · OMB 0920-0595.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0595 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form none assigned HIV Rapid Testing Results Booklet HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Form EZ	Form
none assigned HIV Rapid Testing Results Booklet Attachment #3- p0606dcf OMB.doc	Form

IC Title:

HIV Rapid Testing Performance Evaluation Sample and Laboratory Practices Questionnaire Surveys - HIV Rapid Testing Form EZ

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none assigned				Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 750

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 15 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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