OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Phase 1 completes 65%

IC 205295 under ICR 201402-0910-001 · OMB 0910-0737.

Documents and Forms
Document Name
Document Type
Other-Phase 1
Information Collection (IC) Details

View Information Collection (IC)

Phase 1 completes 65%
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Phase 1 APPENDIX 2_Questionnaire Phase 1.doc Yes Yes Fillable Printable

Health Immunization Management

 

1,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,000 0 0 0 0 1,000
Annual IC Time Burden (Hours) 417 0 0 0 0 417
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.