Information Collection

Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPPSS) Variables

IC 215085 under ICR 201802-0920-006 · OMB 0920-0931.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0931 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0931 Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPPSS) Variables	Form and Instruction
0920-0931 Healthy Homes and Lead Poisoning Prevention Surveillance Att4_HHLPSS Variables.doc	Form and Instruction

IC Title:

Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPPSS) Variables

Agency IC Tracking Number:

0920-0931

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	0920-0931	Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPPSS) Variables	Att4_HHLPSS Variables.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	160	160
Annual IC Time Burden (Hours)	640	640
Annual IC Cost Burden (Dollars)	15,000	15,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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