Information Collection

Fidelity and quality

IC 218695 under ICR 202004-0990-007 · OMB 0990-0438.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0438 can be found here:

Documents and Forms

Document Name Document Type
Fidelity_OMB_0990_0438_rev.docx Other-survey and instructions

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Fidelity and quality	Agency IC Tracking Number:

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
Other-survey and instructions			Fidelity_OMB_0990_0438_rev.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 64	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	128	-40	168
Annual IC Time Burden (Hours)	256	-30	286
Annual IC Cost Burden (Dollars)	0	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.