OMB
.report
Search
0920-0004 Foodborne Outbreak 52.13
National Disease Surveillance Program - II. Disease Summaries
OMB: 0920-0004
IC ID: 178369
OMB.report
HHS/CDC
OMB 0920-0004
ICR 201005-0920-006
IC 178369
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0004 can be found here:
2024-05-07 - No material or nonsubstantive change to a currently approved collection
2023-01-27 - Reinstatement with change of a previously approved collection
Documents and Forms
Document Name
Document Type
FoodborneOutbreak Form 5213.pdf
Instruction
FoodborneOutbreak Form 5213 ReportingInstructions.pdf
Foodborne Outbreak Reporting Instructions
IC Document
NORS Form.pdf
NORS Reporting Form
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
0920-0004 Foodborne Outbreak 52.13
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
Instruction
FoodborneOutbreak Form 5213.pdf
Yes
Yes
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:
54
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
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
1,701
0
0
0
0
1,701
Annual IC Time Burden (Hours)
567
0
0
0
0
567
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Foodborne Outbreak Reporting Instructions
FoodborneOutbreak Form 5213 ReportingInstructions.pdf
01/17/2007
NORS Reporting Form
NORS Form.pdf
12/22/2008
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.