Information Collection

LRN Biennial Requalification

IC 192291 under ICR 202210-0920-015 · OMB 0920-0850.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0850 can be found here:

Documents and Forms

Documents and forms in this information collection
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

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:

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	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 %

table that charts list of burden
	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

table that charts IC Documents
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.