Information Collection

Documentation of Self-Inspection

IC 217510 under ICR 202312-0920-005 · OMB 0920-0576.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0576 Documentation of Self-Inspection	Form
Form 0920-0576 Documentation of self-inspection Documentation of Self-Inspection	Form
0920-0576 Documentation of self-inspection Attachment 9 - Documentaton of Self-inspection.docx	Form
0920-0576 Documentation of self-inspection Attachment 9 - Documentaton of Self-inspection.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	0920-0576				No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0170 National Select Agent Registry/Select Agent Transfer and Entity Registration Information System

FR Citation: 76 FR 4483

Number of Respondents: 233

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	233	-20	253
Annual IC Time Burden (Hours)	233	-20	253
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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