Information Collection

ABCs Surveillance for Non-Invasive Pneumococcal Pneumonia (SNiPP) Case Report Form

IC 215016 under ICR 201803-0920-010 · OMB 0920-0978.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0978 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Non Bacteremic Pneumococcal 2015 ABCs Surveillance for Non-Invasive Pneumococcal Pneumonia (SNiPP) Case Report Form	Form
Form CDC 2016 Surveillance for Non-Invasive Penumococcal Pneumonia (SNiPP) ABCs Surveillance for Non-Invasive Pneumococcal Pneumonia (SNiPP) Case Report Form	Form
Non Bacteremic Pneumococcal 2015 Attachment 03_2015 Non Bacteremic Pneumococcal Disease_OMB.PDF	Form
CDC 2016 Surveillance for Non-Invasive Penumococcal Pneumoni Att. 2 - ABCs SNiPP Case Report Form.pdf	Form

IC Title:

ABCs Surveillance for Non-Invasive Pneumococcal Pneumonia (SNiPP) Case Report Form

Agency IC Tracking Number:

0920-0910

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	none	Non Bacteremic Pneumococcal 2015	Attachment 03_2015 Non Bacteremic Pneumococcal Disease_OMB.PDF		Yes	Yes	Fillable Fileable
Form	CDC	2016 Surveillance for Non-Invasive Penumococcal Pneumonia (SNiPP)	Att. 2 - ABCs SNiPP Case Report Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,250	1,250
Annual IC Time Burden (Hours)	208	208
Annual IC Cost Burden (Dollars)	0	0

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.