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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.