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Federal forms, ICRs, and supporting documents

Information Collection

Consent Form

IC 238163 under ICR 202202-0920-003 · OMB 0920-1281.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Consent Form 0920-19ARD
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-19ARD Consent Form Att C_Consent form.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

1,235 0
   
Individuals or Households
 
   80 %

  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 1,235 0 0 0 0 1,235
Annual IC Time Burden (Hours) 247 0 0 0 0 247
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.