Information Collection

DSP-MRT Standard Tool

IC 219387 under ICR 202109-0930-002 · OMB 0930-0354.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0354 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DSP-MRT Standard T DSP-MRT Standard Tool	Form and Instruction
DSP-MRT Standard T DSP-MRT Standard Tool DSP-MRT Attachment _1 Revised 4-23-21.docx	Form and Instruction
DSP-MRT Standard T DSP-MRT Standard Tool DSP-MRT Attachment _1 Revised 4-23-21.docx	Form and Instruction

IC Title:

DSP-MRT Standard Tool

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	DSP-MRT Standard Tool	DSP-MRT Standard Tool	DSP-MRT Attachment _1 Revised 4-23-21.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: DSP-MRT Standard Tool

FR Citation: 75 FR 28264

Number of Respondents: 521

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,084	1,616	468
Annual IC Time Burden (Hours)	6,252	4,848	1,404
Annual IC Cost Burden (Dollars)	0	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.