Information Collection

State Unintentional Drug Overdose Reporting System (SUDORS)

IC 220172 under ICR 201602-0920-010 · OMB 0920-1128.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1128 can be found here:

Documents and Forms

Document Name Document Type
State Unintentional Drug Overdose Reporting System (SUDORS) Form
SUDORS - screenshots Att E. SUDORS Screen Shots_ICRO.docx Form
Att D. DataElements SUDORS.docx SUDORS Data Elements IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	State Unintentional Drug Overdose Reporting System (SUDORS)	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	none	SUDORS - screenshots	Att E. SUDORS Screen Shots_ICRO.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16	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	14,016	14,016
Annual IC Time Burden (Hours)	7,008	7,008
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SUDORS Data Elements	Att D. DataElements SUDORS.docx	02/18/2016

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