Information Collection

Ventilator Capacity & Supplies - State and Local Health Dept Occupations

IC 243718 under ICR 202105-0920-014 · OMB 0920-1317.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1317 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CDC 57.147 Ventilator Capacity & Supplies - State and Local Health Dept Occupations	Form and Instruction
CDC 57.147 Ventilator Capacity & Supplies CDC 57.147_COVID-19 form_Ventilator Capacity and Supplies_v2 Final.docx	Form and Instruction
CDC 57.147 Ventilator Capacity & Supplies CDC 57.147_COVID-19 form_Ventilator Capacity and Supplies_v2 Final.docx	Form and Instruction

IC Title:

Ventilator Capacity & Supplies - State and Local Health Dept Occupations

Agency IC Tracking Number:

0920-20LW

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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 and Instruction	CDC 57.147	Ventilator Capacity & Supplies	CDC 57.147_COVID-19 form_Ventilator Capacity and Supplies_v2 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: 1,870

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	97,240	97,240
Annual IC Time Burden (Hours)	8,103	8,103
Annual IC Cost Burden (Dollars)	0	0

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.