Information Collection

LRN Surge Events

IC 192293 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⚠️ Notice: This information collection may be referencing outdated material.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 Surge Events	Form and Instruction
0920-0850 Surge Events 7d - LRN Surge Events data elements.docx	Form and Instruction
0920-0850 Surge Events 7d - LRN Surge Events data elements.docx	Form and Instruction

IC Title:

LRN Surge Events

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	Surge Events	7d - LRN Surge Events data elements.docx		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	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	81,250	0	81,250
Annual IC Time Burden (Hours)	325,000	-1,625,000	1,950,000
Annual IC Cost Burden (Dollars)	0	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.