Annual Report for Diabetes Prevention and Control Programs

Automated Management Information System (MIS) for Diabetes Prevention Control Programs

Documents and Forms

Document Name Document Type
Form 1 Annual Report for Diabetes Prevention and Control Programs Form
1 Annual Report for Diabetes Prevention and Control Progra Attachment 3. MIS Annual Report Tabs.ppt Form

Information Collection (IC) Details

IC Title:	Annual Report for Diabetes Prevention and Control Programs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Annual Report for Diabetes Prevention and Control Programs	Attachment 3. MIS Annual Report Tabs.ppt		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 53	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	53	-6	59
Annual IC Time Burden (Hours)	2,703	2,231	472
Annual IC Cost Burden (Dollars)	0	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.