Information Collection

Enhanced Perinatal Surveillance (EPS)

IC 46035 under ICR 201106-0920-003 · OMB 0920-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Enhanced Perinatal Surveillance (EPS)	Form
Enhanced Perinatal Surveillance 0920-0573_att 3(f) EPS_Data_Collectionform _wcover.pdf	Form
0920-0573_att 4(d) EPS Sum of form changes_draft User Guide .pdf Enhanced Perinatal Surveillance Guidance	IC Document

IC Title:

Enhanced Perinatal Surveillance (EPS)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	Enhanced Perinatal Surveillance	0920-0573_att 3(f) EPS_Data_Collectionform _wcover.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC

FR Citation: 57 FR 61812

Number of Respondents: 15

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	2,505	2,505
Annual IC Time Burden (Hours)	2,505	2,505
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Enhanced Perinatal Surveillance Guidance	0920-0573_att 4(d) EPS Sum of form changes_draft User Guide .pdf	11/30/2009

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