Information Collection

Att 4A)_CDC EHDI (HSFS) Directions

IC 207643 under ICR 201702-0920-015 · OMB 0920-0733.

Documents and Forms

Document Name Document Type
Attach_4A_Directions_for_EHDI_Survey_2016.docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att 4A)_CDC EHDI (HSFS) Directions	Agency IC Tracking Number:	0920-0733

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
Instruction			Attach_4A_Directions_for_EHDI_Survey_2016.docx		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59	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
Annual Number of Responses for this IC	59	59
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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