Information Collection

HPV PRC Participants

IC 218879 under ICR 201607-0920-008 · OMB 0920-0950.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0950 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HPV PRC Participants	Form
HPV Participants Att D2 HPV PRC Part Form 110315.docx	Form
Att D1 HPV PRC Descrip.docx HPV PRC Instructions	IC Document

IC Title:

HPV PRC Participants

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	none	HPV Participants	Att D2 HPV PRC Part Form 110315.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0167 Health Resources Utilization Statistics

FR Citation: 49 FR 37693

Number of Respondents: 275

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	Previously Approved
Annual Number of Responses for this IC	275	275
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HPV PRC Instructions	Att D1 HPV PRC Descrip.docx	11/05/2015

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