Report of Verified Case of Tuberculosis (RVCT)

Documents and Forms

Document Name Document Type
Report of Verified Case of Tuberculosis (RVCT) Form
Report of Verified Case of Tuberculosis Att 3_RVCT Form.pdf Form
Attachment 4.pdf Instructions to Respondents IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Report of Verified Case of Tuberculosis (RVCT)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	NA	Report of Verified Case of Tuberculosis	Att 3_RVCT Form.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	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	Previously Approved
Annual Number of Responses for this IC	9,420	-540	9,960
Annual IC Time Burden (Hours)	5,495	-315	5,810
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Instructions to Respondents	Attachment 4.pdf	02/05/2014

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