TB Indicator Reporting Form

Information Collection for Tuberculosis Data from Panel Physicians

OMB: 0920-1102

IC ID: 218237

Information Collection (IC) Details

View Information Collection (IC)

TB Indicator Reporting Form 0920-1102
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none TB Indicator Data Reporting Form Attachment C TB Indicator Reporting Form_2021.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

333 0
   
Private Sector Businesses or other for-profits
 
   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 333 0 -3 0 0 336
Annual IC Time Burden (Hours) 999 0 -9 0 0 1,008
Annual IC Cost Burden (Dollars) 105,115 0 656 0 0 104,459

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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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