Information Collection

Att Z_ Waterborne Diseases Transmission

IC 178372 under ICR 202301-0920-009 · OMB 0920-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0004 can be found here:

Documents and Forms

Document Name Document Type
Form CDC 52.12 Att Z_ Waterborne Diseases Transmission Form
CDC 52.12 NORS - Waterborne Disease Transmission Attachment Z_NORS Waterborne Disease Transmission Form_52.12.pdf Form
CDC 52.12 NORS - Waterborne Disease Transmission Attachment Z_NORS Waterborne Disease Transmission Form_52.12.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att Z_ Waterborne Diseases Transmission	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	CDC 52.12	NORS - Waterborne Disease Transmission	Attachment Z_NORS Waterborne Disease Transmission Form_52.12.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	-59	59
Annual IC Time Burden (Hours)	-20	20
Annual IC Cost Burden (Dollars)	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.