Information Collection

ABES Data Collection Checklist

IC 244330 under ICR 202206-0920-016 · OMB 0920-0493.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0493 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0493 ABES Data Collection Checklist Form and Instruction
0920-0493 ABES Data Collection Checklist Att G_Data Collection Checklist.docx Form and Instruction
0920-0493 ABES Data Collection Checklist Att G_Data Collection Checklist.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	ABES Data Collection Checklist	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-0493	ABES Data Collection Checklist	Att G_Data Collection Checklist.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.