Data Verification Form

Million Hearts Hypertension Control Challenge

OMB: 0920-0976

IC ID: 206921

Information Collection (IC) Details

View Information Collection (IC)

Data Verification Form 0920-0976
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0976 Data Verification Form Attachment 4. Data Verification Form 0920-0976 (unchanged).docm Yes Yes Fillable Fileable

Health Immunization Management

 

40 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 40 0 0 0 0 40
Annual IC Time Burden (Hours) 80 0 0 0 0 80
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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