Registration

National Syndromic Surveillance Program

Documents and Forms

Document Name Document Type
Form 0920-0824 Registration Form and Instruction
0920-0824 Registration Screenshot Att 5 - Registration Screenshot .pdf Form and Instruction
0920-0824 Registration Screenshot Att 5 - Registration Screenshot .pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Registration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	0920-0824	Registration Screenshot	Att 5 - Registration Screenshot .pdf		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records
Title: Epidemiologic Studies and Surveilance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,000	1,850	150
Annual IC Time Burden (Hours)	333	308	25
Annual IC Cost Burden (Dollars)	0	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.