Information Collection

Invasive Methicillin - Resistant - Staphylococcus aureus ABCs Case Report Form

IC 207647 under ICR 201309-0920-007 · OMB 0920-0978.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0978 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Invasive Methicillin - Resistant - Staphylococcus aureus ABCs Case Report Form	Form
Invasive MRSA Attachment 3_2013_ABCs_MRSA_CRF.pdf	Form

IC Title:

Invasive Methicillin - Resistant - Staphylococcus aureus ABCs Case Report Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 301 Public Health Service Act

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	none	Invasive MRSA	Attachment 3_2013_ABCs_MRSA_CRF.pdf		Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

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	6,090	6,090
Annual IC Time Burden (Hours)	2,030	2,030
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.