Information Collection

Web-Based

IC 195903 under ICR 201101-0930-002 · OMB 0930-0322.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Web-based training Web-Based	Form and Instruction
Web-based training Web-based training material-instruments Web Based Training Materials-Instruments.pdf	Form and Instruction

IC Title:

Web-Based

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	Web-based training material-instruments	Web-based training material-instruments	Web Based Training Materials-Instruments.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,756

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	10,168	10,168
Annual IC Time Burden (Hours)	1,585	1,585
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.