Information Collection Request

Public Health Information System

ICR 201805-0583-001 · OMB 0583-0153 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 5200-15 Public Health Information System Form Modified Available
supporting statement ICRPHIS 052018.doc Supporting Statement A Uploaded 2018-05-29 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
196167 Public Health Information System Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2021 36 Months From Approved 01/31/2021
643,008 0 613,480
115,117 0 103,814
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 643,008 613,480 0 0 0 29,528
Annual Time Burden (Hours) 115,117 103,814 0 0 0 11,303
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No