Information Collection

Water Collection

IC 207197 under ICR 201306-0920-001 · OMB 0920-0982.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0982 can be found here:

Documents and Forms

Document Name Document Type
Att 10A2_Home Water Sample Collection Instructions for Participants.docx Instruction
Att 10B_Home Tap Water Collection Procedures for Study Staff.doc Att 10B_Home Tap Water Collection Procedures for Study Staff IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Water Collection	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Instruction			Att 10A2_Home Water Sample Collection Instructions for Participants.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 252

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

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

Documents for IC

Title	Document	Date Uploaded
Att 10B_Home Tap Water Collection Procedures for Study Staff	Att 10B_Home Tap Water Collection Procedures for Study Staff.doc	06/04/2013

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