Email Invite Fluoride Testing data

National Surveillance of Community Water Systems and Corresponding Populations with the Recommended Fluoridation Level

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1319 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-19DO Email Invite Fluoride Testing data Form and Instruction
0920-19DO Email Invitation for fluoride testing data submission 19DO Att. 2c Email Invite Fluoride Testing Final.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Email Invite Fluoride Testing data	Agency IC Tracking Number:	0920-19DO

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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	0920-19DO	Email Invitation for fluoride testing data submission	19DO Att. 2c Email Invite Fluoride Testing Final.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 33	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	33	33
Annual IC Time Burden (Hours)	908	908
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.