Program Administration -Child Aggregate Screens (SSP Local Administrator)

[NCCDPHP] Sealant Efficiency Assessment for Locals and States (SEALS)

OMB: 0920-1289

IC ID: 238600

Information Collection (IC) Details

View Information Collection (IC)

Program Administration -Child Aggregate Screens (SSP Local Administrator) 0920-1289
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1289 Child Aggregate Screens - Add Event 2a. Data Collection Form Electronic.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

162 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,240 0 3,240 0 0 0
Annual IC Time Burden (Hours) 1,134 0 1,134 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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