Annual Update Request (Telephone) State and Local Gov't Organizations

Information Collection of the Resources and Services Database of the National Prevention Information Network: 30 day

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0255 can be found here:

Documents and Forms

Document Name Document Type
Annual Update Request (Telephone) State and Local Gov't Organizations Form and Instruction
Appendix E. Annual Update Request (Telephone) Annual update Request (Telephone.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Annual Update Request (Telephone) State and Local Gov't Organizations	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Appendix E. Annual Update Request (Telephone)	Annual update Request (Telephone.doc		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,220	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,220	3,220
Annual IC Time Burden (Hours)	537	537
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.