Record Abstraction

Enhanced STD Surveillance Network

OMB: 0920-1072

IC ID: 232378

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Record Abstraction 0920-1072
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Data elements Att 5_DataElementTable_V10.2.pdf NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

10 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 60 0 60 0 0 0
Annual IC Time Burden (Hours) 180 0 180 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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