Information Collection

Attachment 11 DDT MIS Add Advisory Group Update Screen

IC 178775 under ICR 200702-0920-003 · OMB 0920-0479.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0479 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 11 DDT MIS Add Advisory Group Update Screen	Form
Add Advisory Group Update Attachment 11 DDT MIS Add Advisory Group Update.pdf	Form

IC Title:

Attachment 11 DDT MIS Add Advisory Group Update Screen

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:

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	Add Advisory Group Update	Attachment 11 DDT MIS Add Advisory Group Update.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 59

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	59	59
Annual IC Time Burden (Hours)	590	590
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.