Information Collection

Annual Synar Report Format

IC 7625 under ICR 201603-0930-008 · OMB 0930-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Report Annual Synar Report Format	Form
FFY 2017 ASR Instructions 2.29.16.docx	Instruction
Report Report FFY 2017 ASR 2.29.2016.docx	Form
C-ASR_public_comments_2014_2016.pdf Comments	IC Document

IC Title:

Annual Synar Report Format

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	Report	Report	FFY 2017 ASR 2.29.2016.docx		Yes	Yes	Fillable Fileable
Instruction			FFY 2017 ASR Instructions 2.29.16.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 59

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	Previously Approved
Annual Number of Responses for this IC	59	59
Annual IC Time Burden (Hours)	1,062	1,062
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Comments	C-ASR_public_comments_2014_2016.pdf	03/05/2013

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