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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.