Information Collection

Att R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report

IC 199058 under ICR 201412-0920-014 · 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⚠️ Notice: This information collection may be referencing outdated material.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 R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report Form
CMRS Weekly 122 CMRS weekly mortality form.pdf Form
CDC 43.5 122 CMRS-City Health Officers or Vital Statistics Regist Att R_122 CMRS - city health officers or vital statistics registrars weekly mortality report.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report	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
Form	none	CMRS Weekly	122 CMRS weekly mortality form.pdf		Yes	Yes	Fillable Printable
Form	CDC 43.5	122 CMRS-City Health Officers or Vital Statistics Registrars Weekly Mortality Report	Att R_122 CMRS - city health officers or vital statistics registrars weekly mortality report.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 122	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 62 %

	Approved	Previously Approved
Annual Number of Responses for this IC	6,344	6,344
Annual IC Time Burden (Hours)	1,269	1,269
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.