Information Collection

Att Y_ Form for Submitting Specimens from Suspected Norovirus Outbreak

IC 178374 under ICR 201407-0920-012 · OMB 0920-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0004 can be found here:

Documents and Forms

Document Name Document Type
Att Y_ Form for Submitting Specimens from Suspected Norovirus Outbreak Form
Form for Submitting Specimens from Suspected Norovirus O Att Y_FORM FOR SUBMITTING SPECIMENS FROM SUSPECTED NOROVIRUS OUTBREAKS.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att Y_ Form for Submitting Specimens from Suspected Norovirus Outbreak	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Form for Submitting Specimens from Suspected Norovirus Outbreaks	Att Y_FORM FOR SUBMITTING SPECIMENS FROM SUSPECTED NOROVIRUS OUTBREAKS.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	100	0	100
Annual IC Time Burden (Hours)	25	17	8
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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