HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA)

Emerging Infections Program

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 0920-0978 HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Form and Instruction
0920-0978 Invasive Methicillin-Sensitive Staphylococcus aureus Hea 19- MSSA2018_OMB_v1.pdf Form and Instruction
0920-0978 Invasive Methicillin-sensitive Staphylococcus aureus (MS Att 8_MSSA2019_OMB_v1_FINAL_KJ_08062018.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA)	Agency IC Tracking Number:	0920-0978-18AXU

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0978	Invasive Methicillin-Sensitive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2018	19- MSSA2018_OMB_v1.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0978	Invasive Methicillin-sensitive Staphylococcus aureus (MSSA) Infection Case Report Form	Att 8_MSSA2019_OMB_v1_FINAL_KJ_08062018.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

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 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	7,540	-2,810	10,350
Annual IC Time Burden (Hours)	3,142	-308	3,450
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.