Information Collection

LRN General Surveillance Testing Results

IC 192290 under ICR 201902-0920-020 · OMB 0920-0850.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0850 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0850 LRN General Surveillance Testing Results	Form and Instruction
0920-0850 General Surveillance Testing Att 3b - General Surveillance Testing.doc	Form and Instruction

IC Title:

LRN General Surveillance Testing Results

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0850	General Surveillance Testing	Att 3b - General Surveillance Testing.doc	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 130

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,250	-500	3,750
Annual IC Time Burden (Hours)	78,000	-12,000	90,000
Annual IC Cost Burden (Dollars)	0	0	0

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.