Information Collection

National Program of Cancer Registries Cancer Surveillance System

IC 6900 under ICR 200911-0920-004 · OMB 0920-0469.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0469 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 4a_Submission Spec.100109.pdf	Other-WORD
Att 4b_burden statement.pdf Att 4b_burden statement	IC Document

IC Title:

National Program of Cancer Registries Cancer Surveillance System

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-WORD			Att 4a_Submission Spec.100109.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 48

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	Previously Approved
Annual Number of Responses for this IC	48	-15	63
Annual IC Time Burden (Hours)	96	-30	126
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 4b_burden statement	Att 4b_burden statement.pdf	10/22/2009

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