Information Collection

Entity Registration (Renewal & Update)

IC 206504 under ICR 201304-0915-002 · OMB 0915-0126.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0126 can be found here:

Documents and Forms

Document Name Document Type
Form 25 Entity Registration (Renewal & Update) Form and Instruction
25 Entity Registration (Renewal & Update) 25.Entity Registration (Renewal and Update).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Entity Registration (Renewal & Update)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

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	25	Entity Registration (Renewal & Update)	25.Entity Registration (Renewal and Update).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15,461	Number of Respondents for Small Entity: 100

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	15,461	15,461
Annual IC Time Burden (Hours)	1,237	1,237
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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