NCHS Application for Vital Statistics Training Form

ICR 200705-0920-003

OMB: 0920-0217

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
New
Supplementary Document
2007-04-18
Supplementary Document
2007-04-18
Supplementary Document
2007-04-18
Supporting Statement A
2007-04-25
ICR Details
0920-0217 200705-0920-003
Historical Active 200406-0920-003
HHS/CDC
NCHS Application for Vital Statistics Training Form
Extension without change of a currently approved collection   No
Regular
Approved without change 07/11/2007
Retrieve Notice of Action (NOA) 05/10/2007
  Inventory as of this Action Requested Previously Approved
07/31/2010 36 Months From Approved 07/31/2007
157 0 157
44 0 44
0 0 0

CDC/NCHS provides free training courses to state, county, and local vital records and vital statistics staff as part of a program to promote uniformity and high quality of national vital statistics data. Clearance is sought for documents that obtain an annual survey of the states regarding their training needs and provide a form for individuals to apply for such training from NCHS.

US Code: 42 USC 242k Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  71 FR 66333 11/14/2006
72 FR 20128 04/23/2007
No

2
IC Title Form No. Form Name
NCHS Application for Vital Statistics Training Form CDC 64.52 Application for Training
Annual Survey of Training Needs None Annual Survey of Training Needs

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 157 157 0 0 0 0
Annual Time Burden (Hours) 44 44 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Changing Forms
No change in burden hours is requested.

$1,000
No
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/10/2007


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