Information Collection

ATTC - Event Description Form

IC 7618 under ICR 201304-0930-002 · OMB 0930-0216.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0216 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Event Description ATTC - Event Description Form	Form and Instruction
Event Description Event Description Form Attachment.1.Event.Description.Form.doc	Form and Instruction
Other.zip Other Attachments	IC Document

IC Title:

ATTC - Event Description Form

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	Event Description Form	Event Description Form	Attachment.1.Event.Description.Form.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Other Attachments	Other.zip	01/27/2010

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