Eligibility Screening Survey, Bhutanese and Burmese

Biomonitoring of Great Lakes Populations Program II

Documents and Forms

Document Name Document Type
Eligibility Screening Survey, Bhutanese and Burmese Form and Instruction
Screening Survey Bhutan Burm Att8a_ScreeningSurveyBhutan_Burm.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Eligibility Screening Survey, Bhutanese and Burmese	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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 and Instruction	none	Screening Survey Bhutan Burm	Att8a_ScreeningSurveyBhutan_Burm.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	21	21
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.