Information Collection

VHF Case Investigation (Short Form) - French

IC 217246 under ICR 201505-0920-008 · OMB 0920-1085.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
VHF Case Investigation (Short Form) - French	Form and Instruction
VHF Case Investigation (Short Form) - French Att2 VHFCaseInvstgnShortForm 20141008 FRNCH.pdf	Form and Instruction

IC Title:

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	None	VHF Case Investigation (Short Form) - French	Att2 VHFCaseInvstgnShortForm 20141008 FRNCH.pdf	None	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,122

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,122	10,122
Annual IC Time Burden (Hours)	1,687	1,687
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.