Information Collection

National ART Surveillance System

IC 43614 under ICR 201905-0920-001 · OMB 0920-0556.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0556 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
National ART Surveillance System	Form and Instruction
National ART Surveillance System NASS screensC1b_v5_04172019_clean.docx	Form and Instruction

IC Title:

National ART Surveillance System

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	none	National ART Surveillance System	NASS screensC1b_v5_04172019_clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 464

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	162,400	162,400
Annual IC Time Burden (Hours)	113,680	113,680
Annual IC Cost Burden (Dollars)	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.