Malaria Case Surveillance Report

National Disease Surveillance Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0009 can be found here:

Documents and Forms

Document Name Document Type
Form CDC 54.1 Malaria Case Surveillance Report Form
CDC 54.1 Malaria Case Surveillance Report ProposedCDC Malaria Form_Oct132009.doc Form
Currentmalaria_form.pdf Current Malaria Form IC Document
CDCMalaria54 1_changesAppenA2009.xls Malaria Changes IC Document

Information Collection (IC) Details

IC Title:	Malaria Case Surveillance Report	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	CDC 54.1	Malaria Case Surveillance Report	ProposedCDC Malaria Form_Oct132009.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems 09-20-0136	FR Citation: 57 FR 62812

Number of Respondents: 55	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,100	1,100
Annual IC Time Burden (Hours)	275	275
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Current Malaria Form	Currentmalaria_form.pdf	02/25/2010
Malaria Changes	CDCMalaria54 1_changesAppenA2009.xls	02/25/2010

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