Information Collection

NVEAIS Data Reporting Instrument

IC 204518 under ICR 201210-0920-008 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NVEAIS Data Reporting Instrument	Form
Attachment 4-NVEAIS Data Reporting Instrument Attach#4_NVEAIS Data Reporting Instrument.doc	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	None	Attachment 4-NVEAIS Data Reporting Instrument	Attach#4_NVEAIS Data Reporting Instrument.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,400

Number of Respondents for Small Entity: 462

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,400	1,400
Annual IC Time Burden (Hours)	2,800	2,800
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.