Information Collection

Management Reporting Tool

IC 219387 under ICR 201512-0930-004 · OMB 0930-0354.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0354 can be found here:

Documents and Forms

Document Name Document Type
Form Management Reporti Management Reporting Tool Form and Instruction
Management Reporti Management Reporting Tool PeP-C_Wireframes_MRT_tool_6-10-2015_forCSAP.docx Form and Instruction
Public_Burden_Statement-02022015.doc Burden_Statement IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Management Reporting Tool	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	Management Reporting Tool	Management Reporting Tool	PeP-C_Wireframes_MRT_tool_6-10-2015_forCSAP.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 69	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	438	438
Annual IC Time Burden (Hours)	1,107	1,107
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Burden_Statement	Public_Burden_Statement-02022015.doc	12/22/2015

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