Information Collection

National Evaluation of the ATTC

IC 184361 under ICR 200804-0930-001 · OMB 0930-0294.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Instruments National Evaluation of the ATTC	Form and Instruction
Instruments Instrument Attachments B-N Data Collection Instruments3-10-08.pdf	Form and Instruction
Attachments A and O.pdf Attachments A and O	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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 and Instruction	Instruments	Instrument	Attachments B-N Data Collection Instruments3-10-08.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,294

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	7,551	7,551
Annual IC Time Burden (Hours)	4,118	4,118
Annual IC Cost Burden (Dollars)	101,904	101,904

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachments A and O	Attachments A and O.pdf	03/28/2008

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.