Information Collection Request

Public Health Information System

ICR 201907-0583-001 · OMB 0583-0153 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
supporting statement ICRPHIS 07082019.doc Supporting Statement A Uploaded 2019-07-08 Available
justificationchangerequest0583-0153 9060-5 March 2019.docx Justification for No Material/Nonsubstantive Change Uploaded 2019-03-14 Repair queued
justificationchangerequest0583-0153 9080-3.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-08-30 Available
justificationchangerequest0583-0153 5200-15 and 9060-6.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-07-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
196167 Public Health Information System Other-screens-Transfer Certificate Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2022 36 Months From Approved 06/30/2021
643,008 0 643,008
115,117 0 115,117
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 643,008 643,008 0 0 0 0
Annual Time Burden (Hours) 115,117 115,117 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No