Information Collection

Annual Reporting Data Elements for RPE

IC 237591 under ICR 202003-0920-012 · OMB 0920-1286.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1286 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Annual Reporting Data Elements for RPE	Form and Instruction
Annual reporting for RPE data elements OMB_no_0920-1286_Annual_Reporting_for_RPE_All_Forms_030920_final.docx	Form and Instruction

IC Title:

Annual Reporting Data Elements for RPE

Agency IC Tracking Number:

0920-1286

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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	none	Annual reporting for RPE data elements	OMB_no_0920-1286_Annual_Reporting_for_RPE_All_Forms_030920_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: 55

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	220	220
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.