Information Collection

TB Indicator Spreadsheet

IC 218237 under ICR 201509-0920-006 · OMB 0920-1102.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1102 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
TB Indicator Spreadsheet	Form and Instruction
TB Indicator Spreadsheet Attachment C TB Indicator Spreadsheet_wInstructions.xls	Form and Instruction

IC Title:

TB Indicator Spreadsheet

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	NA	TB Indicator Spreadsheet	Attachment C TB Indicator Spreadsheet_wInstructions.xls	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 353

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	353	353
Annual IC Time Burden (Hours)	2,648	2,648
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.