Information Collection

Initial Results Information Submission

IC 225079 under ICR 202001-0925-001 · OMB 0925-0586.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0586 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 Initial Results Information Submission	Form and Instruction
2 Results Information Submission Data Entry Forms (screens Attachment 5 - Results Information Submission Data Entry Forms (Screenshots).pdf	Form and Instruction

IC Title:

Initial Results Information Submission

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

Obligation to Respond: Mandatory

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	2	Results Information Submission Data Entry Forms (screenshots)	Attachment 5 - Results Information Submission Data Entry Forms (Screenshots).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 7,400

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-7,400	7,400
Annual IC Time Burden (Hours)	-296,000	296,000
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.