Reference Labs

Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Reference Labs Form
Data Collection Instrument RefLab- C- IC web.docx Form
RefLab- D- IC Word.rtf Word Data Collection Instrument IC Document
RefLab- A- Satisfaction Report.docx Satisfaction Report IC Document
RefLab- B- Lab List.docx CDC IDLs List IC Document
RefLab- E- Intro Email.docx Email Invite IC Document
RefLab- F- APHL Notice.docx APHL eUpdate IC Document
RefLab- G- Reminder.docx Email Reminder Nonresponders IC Document
RefLab- H- APHL Reminder.docx APHL eUpdate Reminder IC Document
RefLab- SSA.docx SSA IC Document
RefLab- SSB.docx SSB IC Document

Information Collection (IC) Details

IC Title:	Reference Labs	Agency IC Tracking Number:	14VO

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
Form	none	Data Collection Instrument	RefLab- C- IC web.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

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

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	9	9
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Word Data Collection Instrument	RefLab- D- IC Word.rtf	04/24/2014
Satisfaction Report	RefLab- A- Satisfaction Report.docx	04/24/2014
CDC IDLs List	RefLab- B- Lab List.docx	04/24/2014
Email Invite	RefLab- E- Intro Email.docx	04/24/2014
APHL eUpdate	RefLab- F- APHL Notice.docx	04/24/2014
Email Reminder Nonresponders	RefLab- G- Reminder.docx	04/24/2014
APHL eUpdate Reminder	RefLab- H- APHL Reminder.docx	04/24/2014
SSA	RefLab- SSA.docx	04/24/2014
SSB	RefLab- SSB.docx	04/24/2014

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