Information Collection

AMP Data Submission Form (Private Research Lab)

IC 255877 under ICR 202209-0920-008 · OMB 0920-1389.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1389 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AMP Data Submission Form (Private Research Lab)	Form
AMP Data Submission Form Att 3a. AMP Enroll&DataReturnForm.pdf	Form
AMP Data Submission Form Att 3a. AMP Enroll&DataReturnForm.pdf	Form

IC Title:

AMP Data Submission Form (Private Research Lab)

Agency IC Tracking Number:

0920-22AW

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	n/a	AMP Data Submission Form	Att 3a. AMP Enroll&DataReturnForm.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	12	12
Annual IC Time Burden (Hours)	9	9
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.