Information Collection

CDC Specimen Submission 50.34 Form

IC 243434 under ICR 202308-0920-008 · OMB 0920-1309.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CDC 50.34_v4.2.21 CDC Specimen Submission 50.34 Form	Form
Form CDC 50.34_v4.2.21 CDC SPECIMEN SUBMISSION FORM: SPECIMENS OF HUMAN ORGAN CDC Specimen Submission 50.34 Form	Form
CDC 50.34_v4.2.21 CDC SPECIMEN SUBMISSION FORM: SPECIMENS OF HUMAN ORGAN Attachment 2A-CDC Specimen Submission 50.34 Form.pdf	Form
CDC 50.34_v4.2.21 CDC SPECIMEN SUBMISSION FORM: SPECIMENS OF HUMAN ORGAN Attachment 2A-CDC Specimen Submission 50.34 Form.pdf	Form

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
Form	CDC 50.34_v4.2.21				Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0106, Specimen Handling for Testing and Related Data

FR Citation: 51 FR 42464

Number of Respondents: 2,098

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
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	25,176	6,262	18,914
Annual IC Time Burden (Hours)	2,098	522	1,576
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.

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