Information Collection

Att 4_TCEO Proposal

IC 37715 under ICR 201604-0920-002 · OMB 0920-0017.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0017 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att. 4- TCEO Proposal Module_01-19-2016.docx	Other-Screen shots

IC Title:

Att 4_TCEO Proposal

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-Screen shots			Att. 4- TCEO Proposal Module_01-19-2016.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-01610-Records of Health Professionals in Disease Prevention and Control Training Programs

FR Citation: 51 FR 42485

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	120	-6,380	6,500
Annual IC Time Burden (Hours)	600	58	542
Annual IC Cost Burden (Dollars)	0	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.