Information Collection

SOAR Data Form - Part II

IC 226017 under ICR 201703-0930-002 · OMB 0930-0329.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0329 can be found here:

Documents and Forms

Document Name Document Type
Form Part II SOAR Data Form - Part II Form and Instruction
Part II Part II Attachment B- Part II (NEW)- Additions to SOAR Data Form 10.24.16.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SOAR Data Form - Part II	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	Part II	Part II	Attachment B- Part II (NEW)- Additions to SOAR Data Form 10.24.16.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	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	75	75
Annual IC Time Burden (Hours)	38	38
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.