Information Collection

Annual Reporting: Standards Evaluation Report (SER)

IC 220109 under ICR 202310-0920-007 · OMB 0920-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0573 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0573 Annual Reporting: Standards Evaluation Report (SER)	Form and Instruction
0920-0573 2024 Standards Evaluation Report (SER) Surveillance Prog Att3d SER PS18-1802_2024.pdf	Form and Instruction
0920-0573 2024 Standards Evaluation Report (SER) Surveillance Prog Att3d SER PS18-1802_2024.pdf	Form and Instruction
Att 2 SER PS18-1802_2024_track changes.docx Att 2_SER 2024 (track changes)	IC Document
Att 2 SER PS18-1802_2024_track changes.docx Att 2_SER 2024 (track changes)	IC Document
Att 3d_SER (WORD)_rev. 2024.docx Att 3d_ SER (WORD) rev.2024	IC Document
Att 3d_SER (WORD)_rev. 2024.docx Att 3d_ SER (WORD) rev.2024	IC Document

IC Title:

Annual Reporting: Standards Evaluation Report (SER)

Agency IC Tracking Number:

0920-0573-24AD

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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 and Instruction	0920-0573	2024 Standards Evaluation Report (SER) Surveillance Program Performance	Att3d SER PS18-1802_2024.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: SORN 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC

FR Citation: 57 FR 62812

Number of Respondents: 59

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	59	59
Annual IC Time Burden (Hours)	472	472
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 2_SER 2024 (track changes)	Att 2 SER PS18-1802_2024_track changes.docx	10/17/2023
Att 3d_ SER (WORD) rev.2024	Att 3d_SER (WORD)_rev. 2024.docx	10/17/2023

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