Information Collection

Gis

IC 214515 under ICR 201501-0930-003 · OMB 0930-0349.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form GIS GIS	Form and Instruction
GIS GIS Attachment 5 Group Collaborative Events for GIS Analysis 12-17-14.docx	Form and Instruction

IC Title:

GIS

Agency IC Tracking Number:

Is this a Common Form? No

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 and Instruction	GIS	GIS	Attachment 5 Group Collaborative Events for GIS Analysis 12-17-14.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 212

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	848	848
Annual IC Time Burden (Hours)	212	212
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.