Information Collection

Mailed Invitation Packet

IC 178538 under ICR 200702-0920-001 · OMB 0920-0741.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0741 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix M2-M4 Introductory Packet .pdf	Other-Response Card
Appendix M.1 Invitation Letters 6-42007 doc.doc Invitation Letter	IC Document

IC Title:

Mailed Invitation Packet

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
Other-Response Card			Appendix M2-M4 Introductory Packet .pdf		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 8,922

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	8,922	8,922
Annual IC Time Burden (Hours)	1,487	1,487
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Invitation Letter	Appendix M.1 Invitation Letters 6-42007 doc.doc	06/05/2007

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