Information Collection

Public Agencies Retrieving and refile

IC 190915 under ICR 201209-0920-007 · OMB 0920-0607.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0607 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 5 - NVDRS Data Elements.docx	Other-Data Elements
Attachment 4 - Data Flow Chart.doc Data Flow Chart	IC Document

IC Title:

Public Agencies Retrieving and refile

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
Other-Data Elements			Attachment 5 - NVDRS Data Elements.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 27

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	27,000	27,000
Annual IC Time Burden (Hours)	13,500	13,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Data Flow Chart	Attachment 4 - Data Flow Chart.doc	09/12/2012

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