Information Collection

CSAP/NOMs

IC 7638 under ICR 201109-0930-003 · OMB 0930-0230.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0230 can be found here:

Documents and Forms

Document Name Document Type
Form NOMs Instruments CSAP/NOMs Form and Instruction
NOMs Instruments NOMs Instruments 128Attachment B NOMs Instruments 110126labflc.doc Form and Instruction
NOMS NOMS Intruments 128Attachment B NOMs Instruments 2.1.12.docx Form and Instruction
128ATTACHMENT A NOMs Review revised301bf.doc NOMs Review IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CSAP/NOMs	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NOMs Instruments	NOMs Instruments	128Attachment B NOMs Instruments 110126labflc.doc		Yes	Yes	Paper Only
Form and Instruction	NOMS	NOMS Intruments	128Attachment B NOMs Instruments 2.1.12.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,271	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 80 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	180,777	-3,003	183,780
Annual IC Time Burden (Hours)	18,739	-784	19,523
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
NOMs Review	128ATTACHMENT A NOMs Review revised301bf.doc	08/31/2011

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