Information Collection

Att BB_ Influenza Virus Electronic year round PHIN-MS

IC 199052 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⚠️ Notice: This information collection may be referencing outdated material.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 BB_Influenza virus (electronic, year round) _PHIN-MS.doc	Other-Variables for Reporting
PHIN cover sheet.docx PHIN Coversheet	IC Document

IC Title:

Att BB_ Influenza Virus Electronic year round PHIN-MS

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 Reporting			Att BB_Influenza virus (electronic, year round) _PHIN-MS.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3

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	156	-728	884
Annual IC Time Burden (Hours)	13	-61	74
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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

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