OMB
No. 0920-0278; Exp. Date: ________
Assurance of
confidentiality – All
information which would permit identification of an individual, a
practice, or an establishment will be held confidential, will be
used for statistical purposes only by NCHS staff, contractors, and
agents only when required and with necessary controls, and will
not be disclosed or released to other persons without the consent
of the individual or establishment in accordance with section
308(d) of the Public Health Service Act (42 USC 242m) and the
Confidential Information Protection and Statistical Efficiency Act
(PL-107-347).
Notice
– Public
reporting burden for this collection of information is estimated
to average 14 minutes per response, including time for reviewing
instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the
collection of information. An agency may not conduct or sponsor,
and a person is not required to respond to, a collection of
information unless it displays a current valid OMB control number.
Send comments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for
reducing burden to: CDC/ATSDR Information Collection Review
Office, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA
(0920-0278).
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