Information Collection

MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Results Worksheet

IC 46480 under ICR 201010-0920-008 · OMB 0920-0600.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0600 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Results Worksheet MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Results Worksheet	Form
Revised Results Worksheet MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Results Worksheet	Form
Results Worksheet 0920-0600 Attachment 4c Gen Instruction and Results Worksheet (2).doc	Form
Revised Results Worksheet NewFormTB Questions.1.doc	Form
0920-0600 Attachment 4d NTM Case History Form.doc Case history example	IC Document
0920-0600 Attachment 4a Pre-Shipment Letter.doc Pre-shipment letter	IC Document
0920-0600 Attachment 4b Shipment and Password Letter.doc Shipment password letter	IC Document
0920-0600 Attachment 4ei Reminder Email.doc Reminder email	IC Document
0920-0600 Attachment 4eii Phone Script.doc Reminder telephone script	IC Document
0920-0600 Attachment 4f Prelim Results Letter.doc Preliminary report	IC Document
0920-0600 Attachment 4g Aggregate Results Letter.doc Aggregate report letter	IC Document

IC Title:

MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Results Worksheet

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
Form	none				Yes	Yes	Fillable Fileable
Form	none				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 132

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	Previously Approved
Annual Number of Responses for this IC	264	264
Annual IC Time Burden (Hours)	132	132
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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