Information Collection

Restaurant Observation

IC 228962 under ICR 202204-0920-004 · OMB 0920-1227.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Restaurant Observation	Form and Instruction
Restaurant Observation P_Att 4 Restaurant Observation Form 201211.docx	Form and Instruction
Restaurant Observation P_Att 4 Restaurant Observation Form 201211.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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	none	Restaurant Observation	P_Att 4 Restaurant Observation Form 201211.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 106

Number of Respondents for Small Entity: 27

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	212	212
Annual IC Time Burden (Hours)	106	106
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.