Information Collection

Att AA_ Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements

IC 199051 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Att AA_INFLUENZA VIRUS (ELECTRONIC, YEAR ROUND), PHLIP_HL7 MESSAGING DATA ELEMENTS.doc	Other-Variables for Electronic Repor
PHLIP cover sheet.docx PHLIP Coversheet	IC Document

IC Title:

Att AA_ Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-Variables for Electronic Reporting			Att AA_INFLUENZA VIRUS (ELECTRONIC, YEAR ROUND), PHLIP_HL7 MESSAGING DATA ELEMENTS.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 49

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	2,548	2,288	260
Annual IC Time Burden (Hours)	212	190	22
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PHLIP Coversheet	PHLIP cover sheet.docx	11/02/2010

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