Information Collection

SDY Module - State Health Personnel

IC 217617 under ICR 201507-0920-009 · OMB 0920-1092.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1092 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SDY Module - State Health Personnel	Form
NCRPCD Case Reporting System - SDY Module Attachment 3_NCRPCD Case Reporting System - SDY Module SDY 0920-15CT.pdf	Form

IC Title:

SDY Module - State Health Personnel

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	NA	NCRPCD Case Reporting System - SDY Module	Attachment 3_NCRPCD Case Reporting System - SDY Module SDY 0920-15CT.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9

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	2,700	2,700
Annual IC Time Burden (Hours)	1,350	1,350
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.