Information Collection

Committee Decision

IC 239003 under ICR 201912-0920-002 · OMB 0920-1294.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1294 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-19BDE Committee Decision	Form and Instruction
0920-19BDE Committee Decision Attachment 3c. Committee Decision MMRIA Screenshots 11 2019.pdf	Form and Instruction

IC Title:

Committee Decision

Agency IC Tracking Number:

0920-19BDE

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	0920-19BDE	Committee Decision	Attachment 3c. Committee Decision MMRIA Screenshots 11 2019.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Vital Statistics for Births, Deaths, Fetal Deaths, Marriages and Divorces Occurring in the United States During Each Year

FR Citation: 49 FR 37695

Number of Respondents: 25

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	750	750
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	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.