Information Collection

Data Abstraction

IC 238999 under ICR 202304-0920-003 · OMB 0920-1294.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1294 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Data Abstraction	Form and Instruction
Data Abstraction Attachment 3a. MMRIA_abstraction_forms.pdf	Form and Instruction
Data Abstraction Attachment 3a. MMRIA_abstraction_forms.pdf	Form and Instruction

IC Title:

Data Abstraction

Agency IC Tracking Number:

0920-1284

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	n/a	Data Abstraction	Attachment 3a. MMRIA_abstraction_forms.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Vital Statistics for Births, Deaths, Fetal Deaths, Marriages and Divorces Occurring in the United States During Each Year

FR Citation: 49 FR 37695

Number of Respondents: 34

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,428	678	750
Annual IC Time Burden (Hours)	21,420	10,170	11,250
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.