Information Collection

National Vital Statistics Report Forms -- line 1 -- Monthly Vital Statistics Report

IC 6670 under ICR 201202-0920-009 · OMB 0920-0213.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0213 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 National Vital Statistics Report Forms -- line 1 -- Monthly Vital Statistics Report	Form
1 Monthly Vital Statistics Report NVSR 2012-2015 Att B Monthly Form 120111.doc	Form

IC Title:

National Vital Statistics Report Forms -- line 1 -- Monthly Vital Statistics Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	1	Monthly Vital Statistics Report	NVSR 2012-2015 Att B Monthly Form 120111.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 91

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,092	1,092
Annual IC Time Burden (Hours)	182	182
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.