Information Collection

Gulf States Population Survey

IC 197081 under ICR 201103-0920-008 · OMB 0920-0885.

Documents and Forms

Document Name Document Type
Gulf States Population Survey Form
Gulf States Population Survey GSPS Questions ICR 3-02-2011 .docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Gulf States Population Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Form	none	Gulf States Population Survey	GSPS Questions ICR 3-02-2011 .docx		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40,000	40,000
Annual IC Time Burden (Hours)	20,000	20,000
Annual IC Cost Burden (Dollars)	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.