Information Collection

Submission of Data File to CDC

IC 257195 under ICR 202305-0920-012 · OMB 0920-1273.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1273 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Submission of data file to CDC.docx	Instruction
Submission of data file to CDC.docx	Instruction

IC Title:

Submission of Data File to CDC

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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
Instruction			Submission of data file to CDC.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: SORN 09-20-0160 Records of Subjects in Health Promotion Studies

FR Citation: 51 FR 42483

Number of Respondents: 50

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	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	300	300
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.