Information Collection

Otp

IC 184923 under ICR 200805-0930-002 · OMB 0930-0296.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OTP Mortality Repo OTP	Form and Instruction
OTP Mortality Repo Attachment C - OTP Mortality Reporting Form Attachment C.doc	Form and Instruction
Attachment A.doc Attachment A - Public Comments	IC Document
Attachment B.doc Attachment B - Letter	IC Document
Attachment D.doc Attachment D - Fax Instructions	IC Document
Attachment E.doc Attachment E - Online Instructions	IC Document

IC Title:

OTP

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	OTP Mortality Reporting Form	Attachment C - OTP Mortality Reporting Form	Attachment C.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,150

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,300	2,300
Annual IC Time Burden (Hours)	1,150	1,150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment A - Public Comments	Attachment A.doc	05/15/2008
Attachment B - Letter	Attachment B.doc	05/15/2008
Attachment D - Fax Instructions	Attachment D.doc	05/15/2008
Attachment E - Online Instructions	Attachment E.doc	05/15/2008

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