Information Collection

Neonatal Group B Streptococcal Disease Prevention Tracking Form

IC 186330 under ICR 200808-0920-010 · OMB 0920-0802.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0802 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form no number Neonatal Group B Streptoccal Disease Prevention Tracking Form Neonatal Group B Streptococcal Disease Prevention Tracking Form	Form
no number Neonatal Group B Streptoccal Disease Prevention Tracking Attachment 6_NeonatalGroupBSrtepTrackingFormFinal_Ext GBS CRF_JAN2008.pdf	Form
Attachment 9 FINAL_instruct EXTGBS_2008.doc Instructions for ABCs Neonatal Group B Streptococcal Tracking Form	IC Document
Coversheet Neonatal Group B Strep Tracking Form7_23_08ldl.doc Cover sheet for ABCs Neonatal Tracking Form	IC Document

IC Title:

Neonatal Group B Streptococcal Disease Prevention Tracking Form

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	no number				Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	370	370
Annual IC Time Burden (Hours)	123	123
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Instructions for ABCs Neonatal Group B Streptococcal Tracking Form		08/11/2008
Cover sheet for ABCs Neonatal Tracking Form		08/11/2008

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

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