Information Collection

STOP Act Supplemental

IC 249487 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⚠️ Notice: This information collection may be referencing outdated material.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 STOP Act Supplemen STOP Act Supplemental	Form and Instruction
STOP Act Supplemen STOP Act Supplemental DSP MRT Attachment _5 STOPAct _NEW.docx	Form and Instruction
STOP Act Supplemen STOP Act Supplemental DSP MRT Attachment _5 STOPAct _NEW.docx	Form and Instruction

IC Title:

STOP Act Supplemental

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	STOP Act Supplemental	STOP Act Supplemental	DSP MRT Attachment _5 STOPAct _NEW.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: STOP Act Supplemental

FR Citation: 75 FR 28264

Number of Respondents: 133

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
Annual Number of Responses for this IC	133	133
Annual IC Time Burden (Hours)	133	133
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.