Information Collection

3 Month Long-Term Email Invitation

IC 225770 under ICR 201702-0920-011 · OMB 0920-0995.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0995 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 36-3 Month Long-Term email invitation screenshot.docx	Instruction
Att 35-3 Month Long-Term email invitation wordversion.docx Att 35-3 Month Long-Term email invitation wordversion	IC Document

IC Title:

3 Month Long-Term Email Invitation

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
Instruction			Att 36-3 Month Long-Term email invitation screenshot.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Records of Health Professionals in Disease Prevention and Control Trainnig Programs

FR Citation: 51 FR 226

Number of Respondents: 660

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	660	660
Annual IC Time Burden (Hours)	11	11
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 35-3 Month Long-Term email invitation wordversion	Att 35-3 Month Long-Term email invitation wordversion.docx	02/21/2017

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