Information Collection

Trac

IC 212087 under ICR 201510-0930-003 · OMB 0930-0343.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TRAC TRAC	Form and Instruction
TRAC TRAC Attachment 2 TRAC 6 17 2014.pdf	Form and Instruction
Attachment 4 Composition of Proposed CoC TRACTool.docx Composition of Proposed CoC TRAC Tool	IC Document

IC Title:

TRAC

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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	TRAC	TRAC	Attachment 2 TRAC 6 17 2014.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-2,196	2,196
Annual IC Time Burden (Hours)	-397	397
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Composition of Proposed CoC TRAC Tool	Attachment 4 Composition of Proposed CoC TRACTool.docx	06/26/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.