Information Collection

LRN Biennial Requalification

IC 192291 under ICR 201303-0920-002 · OMB 0920-0850.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0850 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 3e- Screen shots of Biennial Requalification through LRN websi....docx	Other-Screenshots
Attachment 3a LRN Biennial Requalification data elements.doc Data Elements	IC Document

IC Title:

LRN Biennial Requalification

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
Other-Screenshots			Attachment 3e- Screen shots of Biennial Requalification through LRN websi....docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	150	50	100
Annual IC Time Burden (Hours)	300	100	200
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Data Elements	Attachment 3a LRN Biennial Requalification data elements.doc	02/28/2013

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