Information Collection Request

Information Collection for Tuberculosis Data from Panel Physicians

ICR 202108-0920-011 · OMB 0920-1102 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
TB Indicator Reporting Form Form Modified Missing upstream
Attachment E PIA Signed.pdf Supplementary Document Uploaded 2021-08-26 Repair queued
Attachment D TB Indicators IRB Form.pdf Supplementary Document Uploaded 2021-08-26 Missing upstream
Attachment F Published Federal Register 0920-1102.pdf Supplementary Document Uploaded 2021-08-26 Repair queued
Attachment A3 - 42 CFR Part 34.pdf Supplementary Document Uploaded 2021-08-26 Missing upstream
Attachment A2 - Public Health Service Act 42 USC 252.docx Supplementary Document Uploaded 2021-08-26 Available
Attachment A1-Immigration and Nationality Act 8 U.S.C. § 1182.pdf Supplementary Document Uploaded 2021-08-26 Repair queued
SupSta B 0920-1102 TB Indicators Revision.docx Supporting Statement B Uploaded 2021-08-26 Available
SupSta A 0920-1102 TB Indicators Revision_final.docx Supporting Statement A Uploaded 2021-08-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
218237 TB Indicator Reporting Form Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 09/30/2021
333 336
999 1,008
105,115 104,459





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
TB Indicator Reporting Form none TB Indicator Data Reporting Form

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 333 336 0 -3 0 0
Annual Time Burden (Hours) 999 1,008 0 -9 0 0
Annual Cost Burden (Dollars) 105,115 104,459 0 656 0 0


Reginfo record details
  No