Information Collection

Missing Report from Query Form

IC 229942 under ICR 202101-0915-002 · OMB 0915-0126.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0126 can be found here:

Documents and Forms

Document Name Document Type
Form 40 Missing Report from Query Form Form and Instruction
40 Missing Report from Query_0915-0126.pdf Missing Report from Query_0915-0126.pdf Form and Instruction
40 Missing Report from Query_0915-0126.pdf Missing Report from Query_0915-0126.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Missing Report from Query Form	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
Form and Instruction	40	Missing Report from Query_0915-0126.pdf	Missing Report from Query_0915-0126.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 10

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	10	-19	29
Annual IC Time Burden (Hours)	1	-2	3
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.