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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.