Information Collection

Annual Reporting Data Elements for RPE (Subsequent Reporting)

IC 237592 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form noen Annual Reporting Data Elements for RPE (Subsequent Reporting) Form and Instruction
noen Annual reporting of RPE data elements - subsequent repor OMB_no_0920-1286_Annual_Reporting_for_RPE_All_Forms_030920_final.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Reporting Data Elements for RPE (Subsequent Reporting)	Agency IC Tracking Number:	0920-1286

Is this a Common Form? No		IC Status: Modified

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	noen	Annual reporting of RPE data elements - subsequent reporting	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 %

	Approved	Previously Approved
Annual Number of Responses for this IC	110	110
Annual IC Time Burden (Hours)	220	220
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.