Information Collection

Annual Synar Report Format

IC 7625 under ICR 201303-0930-001 · OMB 0930-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
B-FFY 2014 ASR Instructions.docx	Instruction
Report Format Report Format FFY 2014 ASR_proposed_4_30_13.docx	Form
C-ASR_public_comments_2014_2016.pdf Comments	IC Document

IC Title:

Annual Synar Report Format

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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
Instruction			B-FFY 2014 ASR Instructions.docx		Yes	Yes	Fillable Printable
Form	Report Format	Report Format	FFY 2014 ASR_proposed_4_30_13.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 59

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	59	59
Annual IC Time Burden (Hours)	1,062	1,062
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Comments	C-ASR_public_comments_2014_2016.pdf	03/05/2013

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