CDC Specimen Submission 50.34 Form

[NCEZID] Enterprise Laboratory Information Management System

Documents and Forms

Document Name Document Type
Form CDC 50.34_v4.2.21 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

Information Collection (IC) Details

IC Title:	CDC Specimen Submission 50.34 Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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	CDC SPECIMEN SUBMISSION FORM: SPECIMENS OF HUMAN ORGAN	Attachment 2A-CDC Specimen Submission 50.34 Form.pdf		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 %

	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

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.