Information Collection

ACBS Data Submission Layout - Child

IC 243153 under ICR 202306-0920-014 · OMB 0920-1204.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att5h ACBS Child DataSbmssnLayout 2023 Rev.docx	Other-Data Submission Layout - Child
Att5h ACBS Child DataSbmssnLayout 2023 Rev.docx	Other-Data Submission Layout - Child

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-Data Submission Layout - Child			Att5h ACBS Child DataSbmssnLayout 2023 Rev.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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	480	480
Annual IC Time Burden (Hours)	200	200
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.