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Neonatal Group B Streptococcal Disease Prevention Tracking Form
Active Bacterial Core Surveillance (ABCs)
OMB: 0920-0802
IC ID: 186330
OMB.report
HHS/CDC
OMB 0920-0802
ICR 200903-0920-005
IC 186330
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0802 can be found here:
2010-04-19 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Neonatal Group B Streptococcal Disease Prevention Tracking Form
Form
Active Bacterial Core Surveillance Neonatal Infection Ex
Attachment 4_Ext GBS CRF 2009.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
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Neonatal Group B Streptococcal Disease Prevention Tracking Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
none
Active Bacterial Core Surveillance Neonatal Infection Expanded Tracking Form
Attachment 4_Ext GBS CRF 2009.pdf
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
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 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
370
0
0
0
0
370
Annual IC Time Burden (Hours)
123
0
0
0
0
123
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Instructions for ABCs Neonatal Group B Streptococcal Tracking Form
Attachment 9 FINAL_instruct EXTGBS_2008.doc
08/11/2008
Cover sheet for ABCs Neonatal Tracking Form
Coversheet Neonatal Group B Strep Tracking Form7_23_08ldl.doc
08/11/2008
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.