Information Collection

GLS Campus Case Studies

IC 189722 under ICR 200906-0930-002 · OMB 0930-0305.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Instruments GLS Campus Case Studies	Form and Instruction
Instruments Instruments Instruments.zip	Form and Instruction
Other Documents.zip Other Attachments	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	Instruments	Instruments.zip		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,770

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	1,770	1,770
Annual IC Time Burden (Hours)	1,017	1,017
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Other Attachments	Other Documents.zip	06/12/2009

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