Information Collection

Communicable disease testing and adverse outcome reports

IC 225389 under ICR 201609-0990-001 · OMB 0990-0457.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NTRUS Survey_Section 7.docx	Other-survey
Cover Page_Draft.docx Instrument cover page	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-survey			NTRUS Survey_Section 7.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 35

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
Annual Number of Responses for this IC	35	35
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Instrument cover page	Cover Page_Draft.docx	06/19/2017

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