Information Collection

Standard Data Items Collected

IC 237544 under ICR 201908-0920-003 · OMB 0920-0469.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0469 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0469 Standard Data Items Collected Form and Instruction
0920-0469 Data Items Collected 0469 NPCR CSS Att 3a Data Items by Diagnosis Year 1995-2017 Final.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Standard Data Items Collected	Agency IC Tracking Number:	0920-0469

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0469	Data Items Collected	0469 NPCR CSS Att 3a Data Items by Diagnosis Year 1995-2017 Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Records of Subjects in Health Promotion and Education Studies	FR Citation: 51 FR 42484

Number of Respondents: 50	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	100	100
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.