Information Collection

Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)

IC 6884 under ICR 201906-0920-013 · OMB 0920-0457.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0457 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)	Form and Instruction
Follow-up and Treatment of Contacts to Tuberculosis Case Att 3a_Form Follow-up.Treatment_Contacts to TB Cases form.instructions.docx	Form and Instruction

IC Title:

Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)

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	n/a	Follow-up and Treatment of Contacts to Tuberculosis Cases	Att 3a_Form Follow-up.Treatment_Contacts to TB Cases form.instructions.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 67

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	67	-33	100
Annual IC Time Burden (Hours)	134	84	50
Annual IC Cost Burden (Dollars)	3,617	3,617	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.