Information Collection

Lab-to-Lab Form

IC 253395 under ICR 202301-0920-010 · OMB 0920-1383.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1383 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-22BY Lab-to-Lab Form	Form and Instruction
Form 0920-22BY Lab-to-Lab Form Lab-to-Lab Form	Form and Instruction
0920-22BY Lab-to-Lab Form Attachment G_Lab-to-lab Form.docx	Form and Instruction
0920-22BY Lab-to-Lab Form Attachment G_Lab-to-lab Form.docx	Form and Instruction

IC Title:

Lab-to-Lab Form

Agency IC Tracking Number:

0920-22BY

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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	0920-22BY				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Quarantine-and-Traveler-Related Activities

FR Citation: 83 FR 6591

Number of Respondents: 2

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	2	2
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.

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