Attachment 15 DDT MIS Edit Additional Accomplishments Screen

Automated Management Information System (MIS) for Diabetes Control Programs

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Attachment 15 DDT MIS Edit Additional Accomplishments Screen Form
Edit Additional Accomplishments Attachment 15 DDT MIS Edit Additional Accomplishment.pdf Form

Information Collection (IC) Details

IC Title:	Attachment 15 DDT MIS Edit Additional Accomplishments Screen	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form	None	Edit Additional Accomplishments	Attachment 15 DDT MIS Edit Additional Accomplishment.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 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	59	-92	92	59
Annual IC Time Burden (Hours)	472	236	0	236
Annual IC Cost Burden (Dollars)	0	-1,000	0	1,000

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.