LRN Biennial Requalification

[NCEZID] Laboratory Response Network

Documents and Forms

Document Name Document Type
Form 0920-0850 LRN Biennial Requalification Form and Instruction
0920-0850 Biennial Requalification 7a - LRN Biennial Requalification data elements.docx Form and Instruction
0920-0850 Biennial Requalification 7a - LRN Biennial Requalification data elements.docx Form and Instruction
Attachment 3a LRN Biennial Requalification data elements.doc Data Elements IC Document
Attachment 3a LRN Biennial Requalification data elements.doc Data Elements IC Document

Information Collection (IC) Details

IC Title:	LRN Biennial Requalification	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	0920-0850	Biennial Requalification	7a - LRN Biennial Requalification data elements.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 130	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	130	130
Annual IC Time Burden (Hours)	260	260
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Data Elements	Attachment 3a LRN Biennial Requalification data elements.doc	02/28/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.