Racial and Ethnic Approaches to Community Health across the US Management Information System

Documents and Forms

Document Name Document Type
Form no number Racial and Ethnic Approaches to Community Health across the US Management Information System Form and Instruction
no number REACH US Management Information System Design Document Attachment 3_Design Document.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Racial and Ethnic Approaches to Community Health across the US Management Information System	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	no number	REACH US Management Information System Design Document	Attachment 3_Design Document.doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 40

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	120	120
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.