Information Collection Request

Information Collection for Tuberculosis Data from Panel Physicians

ICR 201808-0920-002 · OMB 0920-1102 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
TB Indicator Reporting Form Form Modified Available
Attachment E - PIA.pdf Supplementary Document Uploaded 2018-08-06 Available
Attachment D TB Indicators IRB Form.pdf Supplementary Document Uploaded 2018-08-06 Available
Attachment B - 60-day FRN.pdf Supplementary Document Uploaded 2018-08-06 Available
Attachment A3 - 42 CFR Part 34.pdf Supplementary Document Uploaded 2018-08-06 Available
Attachment A2 - Public Health Service Act 42 U.S.C. § 252.pdf Supplementary Document Uploaded 2018-08-06 Available
Attachment A1 - Immigration and Nationality Act 8 U.S.C. § 1182.pdf Supplementary Document Uploaded 2018-08-06 Available
SupSta B TB Indicators Revision 2019_OPRA_MRH2.docx Supporting Statement B Uploaded 2018-08-06 Available
SupSta A TB Indicators 2019 Revision_OPRA_MRH2.docx Supporting Statement A Uploaded 2018-08-31 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
218237 TB Indicator Reporting Form Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2021 36 Months From Approved 02/28/2019
336 0 353
1,008 0 2,648
104,459 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
TB Indicator Reporting Form none TB Indicator Data Reporting Form

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 336 353 0 -17 0 0
Annual Time Burden (Hours) 1,008 2,648 0 -1,640 0 0
Annual Cost Burden (Dollars) 104,459 0 0 104,459 0 0


Reginfo record details
  No