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Freely Associated States - One-time Addition of Diseases and Data Elements
National Notifiable Diseases Surveillance System (NNDSS)
OMB: 0920-0728
IC ID: 235861
OMB.report
HHS/CDC
OMB 0920-0728
ICR 202006-0920-012
IC 235861
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0728 can be found here:
2024-02-05 - Revision of a currently approved collection
2023-06-09 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Att 5 - Core Data.xlsx
Other-Data elements
Att 6 - Laboratory Data.xlsx
Other-Data elements
Att 7 - Vaccine Data.xlsx
Other-Data elements
Att 8 - VPD Data.xlsx
Other-Data elements
Att 10 - Disease-Specific Data_06172020.xlsx
Other-Data elements
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Freely Associated States - One-time Addition of Diseases and Data Elements
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-Data elements
Att 5 - Core Data.xlsx
Yes
Yes
Fillable Fileable
Other-Data elements
Att 6 - Laboratory Data.xlsx
Yes
Yes
Fillable Fileable
Other-Data elements
Att 7 - Vaccine Data.xlsx
Yes
Yes
Fillable Fileable
Other-Data elements
Att 8 - VPD Data.xlsx
Yes
Yes
Fillable Fileable
Other-Data elements
Att 10 - Disease-Specific Data_06172020.xlsx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
76 FR 4458
Number of Respondents:
3
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3
0
0
0
0
3
Annual IC Time Burden (Hours)
22
0
12
0
0
10
Annual IC Cost Burden (Dollars)
555
0
93
0
0
462
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.