Information Collection

Administrator

IC 194043 under ICR 201010-0930-001 · OMB 0930-0317.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Administrative Sta Administrator	Form and Instruction
Administrative Sta Administrative Staff Instruments Attachment 3-Administrative Staff Instruments.pdf	Form and Instruction
Attachment 4-Administrative Staff Other.pdf Administrative Staff Other	IC Document

IC Title:

Administrator

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 and Instruction	Administrative Staff Instruments	Administrative Staff Instruments	Attachment 3-Administrative Staff Instruments.pdf		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32

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
Annual Number of Responses for this IC	64	64
Annual IC Time Burden (Hours)	48	48
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Administrative Staff Other	Attachment 4-Administrative Staff Other.pdf	10/20/2010

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