Investigation Reporting and Evaluation

National HIV Surveillance System (NHSS)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:

Documents and Forms

Document Name Document Type
Att 4d_D2C-NIC-Monitoring-and-Evaluation-Guidance Final.pdf Other-Reporting Guidance: Data-to-Ca
Att 4e_DETECTING HIV TRANSMISSION CLUSTERS.pdf Technical Guidance: Detecting HIV Transmission Clusters IC Document

Information Collection (IC) Details

IC Title:	Investigation Reporting and Evaluation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Reporting Guidance: Data-to-Care			Att 4d_D2C-NIC-Monitoring-and-Evaluation-Guidance Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC	FR Citation: 57 FR 62812

Number of Respondents: 59	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
Annual Number of Responses for this IC	53,159	53,159
Annual IC Time Burden (Hours)	886	886
Annual IC Cost Burden (Dollars)	23,922	23,922

Documents for IC

Title	Document	Date Uploaded
Technical Guidance: Detecting HIV Transmission Clusters	Att 4e_DETECTING HIV TRANSMISSION CLUSTERS.pdf	06/26/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.