Information Collection

Tobacco Control Programs

IC 194060 under ICR 201310-0920-001 · OMB 0920-0870.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0870 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Tobacco Control Programs	Form
CDMIS Attachment 4 OMB 0920-0870 Screenshot Final.pdf	Form

IC Title:

Tobacco Control Programs

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	none	CDMIS	Attachment 4 OMB 0920-0870 Screenshot Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 53

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	106	106
Annual IC Time Burden (Hours)	636	636
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.