Information Collection

Recruitment of prospective data source entities

IC 190574 under ICR 200909-0920-001 · OMB 0920-0824.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0824 can be found here:

Documents and Forms

Document Name Document Type
0920xxxx_att3_BioSense Enablement Preparation Workbook MDS.xls Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Recruitment of prospective data source entities	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 241, 247b, 247d-4 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			0920xxxx_att3_BioSense Enablement Preparation Workbook MDS.xls		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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