Information Collection

States - Weekly automated

IC 209482 under ICR 201803-0920-017 · OMB 0920-0728.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0728 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 5 - Core Data.xlsx	Other-Data elements
Att 6 - Laboratory Data.xlsx	Other-Data elements
Att 7 - Vaccine Data.xlsx	Other-Vaccine data
Att 8 - Vaccine Preventable Disease Data.xlsx	Other-Data elements
Att 10 - Disease-Specific Data.xlsx	Other-Data elements

IC Title:

States - Weekly automated

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data elements	Att 6 - Laboratory Data.xlsx	Yes	Yes	Fillable Fileable
Other-Vaccine data	Att 7 - Vaccine Data.xlsx	Yes	Yes	Fillable Fileable
Other-Data elements	Att 8 - Vaccine Preventable Disease Data.xlsx	Yes	Yes	Fillable Fileable
Other-Data elements	Att 10 - Disease-Specific Data.xlsx	Yes	Yes	Fillable Fileable
Other-Data elements	Att 5 - Core Data.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 76 FR 4458

Number of Respondents: 50

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	2,600	2,600
Annual IC Time Burden (Hours)	867	867
Annual IC Cost Burden (Dollars)	38,168	38,168

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.