Information Collection

Specimen collection - fingerprick

IC 238015 under ICR 201906-0920-008 · OMB 0920-1271.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
fingerprick IC.docx	Other-Blood Specimen Collection

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Other-Blood Specimen Collection			fingerprick IC.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 958

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	958	958
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	579	579

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.