Information Collection

TTA Follow up Form

IC 252648 under ICR 202204-0930-002 · OMB 0930-0389.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0389 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TTA Follow up Form TTA Follow up Form	Form and Instruction
TTA Follow up Form TTA Follow up Form Attachment 3_TTA Follow Up Form_1-28-2022.docx	Form and Instruction
TTA Follow up Form TTA Follow up Form Attachment 3_TTA Follow Up Form_1-28-2022.docx	Form and Instruction

IC Title:

TTA Follow up Form

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	TTA Follow up Form	TTA Follow up Form	Attachment 3_TTA Follow Up Form_1-28-2022.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: TTA Follow up Form

FR Citation: 75 FR 28264

Number of Respondents: 25,000

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	25,000	25,000
Annual IC Time Burden (Hours)	4,000	4,000
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.