Information Collection

Assessment of the Tuberculosis Laboratory Aggregate Report

IC 223710 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Assessment of the Tuberculosis Laboratory Aggregate Report	Form
Assessment of the TB Laboratory Aggregate Report Att C_Intrument-Web Version.docx	Form
EVAL-TB-AG-SSA.docx Supporting Statement A	IC Document
EVAL-TB-AG-SSB.docx Supporting Statement B	IC Document
Att A_Public Health Laboratories.docx Public Health Laboratories	IC Document
Att B_Instrument-Word Version.docx Survey - word	IC Document
Att D_Notification Email.docx Notification Email	IC Document
Att E_Reminder Email.docx Reminder Email	IC Document

IC Title:

Assessment of the Tuberculosis Laboratory Aggregate Report

Agency IC Tracking Number:

16BEZ

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	none	Assessment of the TB Laboratory Aggregate Report	Att C_Intrument-Web Version.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 58

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	58	58
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A	EVAL-TB-AG-SSA.docx	09/26/2016
Supporting Statement B	EVAL-TB-AG-SSB.docx	09/26/2016
Public Health Laboratories	Att A_Public Health Laboratories.docx	09/26/2016
Survey - word	Att B_Instrument-Word Version.docx	09/26/2016
Notification Email	Att D_Notification Email.docx	09/26/2016
Reminder Email	Att E_Reminder Email.docx	09/26/2016

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