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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.