Information Collection

Cities - Reporting

IC 209484 under ICR 201410-0920-006 · OMB 0920-0728.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0728 can be found here:

Documents and Forms

Document Name Document Type
Attachment 4 Core Data.xlsx Other-Data Elements
Attachment 5 Disease-Specific Data.xlsx Other-Data Elements

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cities - Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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
Other-Data Elements			Attachment 4 Core Data.xlsx		Yes	Yes	Fillable Fileable
Other-Data Elements			Attachment 5 Disease-Specific Data.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 6812

Number of Respondents: 2	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	104	104
Annual IC Time Burden (Hours)	1,040	1,040
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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