Information Collection

Trac

IC 212087 under ICR 201406-0930-004 · OMB 0930-0343.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0343 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TRAC TRAC	Form and Instruction
TRAC TRAC Attachment 2 TRAC 6 17 2014.pdf	Form and Instruction
Attachment 4 Composition of Proposed CoC TRACTool.docx Composition of Proposed CoC TRAC Tool	IC Document

IC Title:

TRAC

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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 and Instruction	TRAC	TRAC	Attachment 2 TRAC 6 17 2014.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

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
Annual Number of Responses for this IC	2,196	2,196
Annual IC Time Burden (Hours)	397	397
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Composition of Proposed CoC TRAC Tool	Attachment 4 Composition of Proposed CoC TRACTool.docx	06/26/2014

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