Information Collection

N-ssats Bc

IC 191116 under ICR 201210-0930-005 · OMB 0930-0106.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0106 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form N-SSATS 2014 abbre N-SSATS BC	Form and Instruction
N-SSATS 2014 abbre N-SSATS 2014 abbreviated questionnaire Attachment B2 - N-SSATS 2014 abbreviated questionnaire.docx	Form and Instruction
Attachment B10 - between cycle N-SSATS advance letter.docx between cycle N-SSATS advance letter	IC Document

IC Title:

N-SSATS BC

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 and Instruction	N-SSATS 2014 abbreviated questionnaire	N-SSATS 2014 abbreviated questionnaire	Attachment B2 - N-SSATS 2014 abbreviated questionnaire.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

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	2,000	2,000
Annual IC Time Burden (Hours)	840	840
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
between cycle N-SSATS advance letter	Attachment B10 - between cycle N-SSATS advance letter.docx	10/22/2012

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