Information Collection

Traditional Foods Shared Data Elements

IC 197195 under ICR 201404-0920-003 · OMB 0920-0889.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Traditional Foods Shared Data Elements	Form
Traditional Foods SDE Reporting Att 4a. Traditional Foods SDE Oct 2012.pdf	Form
Att 4b. Partner Notification-Shared Data Elements.doc Advance Letter	IC Document
Att 4c. Email with Link to SDE.doc Cover Email	IC Document

IC Title:

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	Traditional Foods SDE Reporting	Att 4a. Traditional Foods SDE Oct 2012.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 16

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	16	-18	34
Annual IC Time Burden (Hours)	32	-36	68
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Advance Letter	Att 4b. Partner Notification-Shared Data Elements.doc	04/09/2014
Cover Email	Att 4c. Email with Link to SDE.doc	04/09/2014

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