Information Collection

Enhanced Data Collection During COVID-19 Pandemic Form (daily)

IC 245853 under ICR 202102-0920-009 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Enhanced Data Collection During COVID-19 Pandemic Form (daily)	Form
EDC During COVID-19 Pandemic Attachment H. Enhanced Data Collection (EDC) During COVID-19 Pandemic Form.docx	Form
EDC During COVID-19 Pandemic Attachment H. Enhanced Data Collection (EDC) During COVID-19 Pandemic Form.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	none	EDC During COVID-19 Pandemic	Attachment H. Enhanced Data Collection (EDC) During COVID-19 Pandemic Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 130

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	47,450	47,450
Annual IC Time Burden (Hours)	11,863	11,863
Annual IC Cost Burden (Dollars)	996,450	996,450

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.