Information Collection

[NCZEID]TB Care Finder

IC 263184 under ICR 202402-0920-010 · OMB 0920-1071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1071-24AU [NCZEID]TB Care Finder	Form and Instruction
0920-1071-24AU TB Care Finder info requested to TB control programs PRA TB Care Finder info requested to TB control programs PRA 10.23.docx	Form and Instruction
Human Subjects Determination.pdf Human Subjects Determination	IC Document
Service Delivery Fast Track Template TBCF_BR v2.docx Request for Approval	IC Document
TB-Care-Finder_Instructions_TB-Pgms_Hlth-Depts PRA 10.23.docx TB-Care-Finder_Instructions_TB-Pgms_Hlth-Depts PRA 10.23	IC Document
TBCF Participant Invitation 10.23.docx TBCF Participant Invitation 10.23	IC Document

IC Title:

[NCZEID]TB Care Finder

Agency IC Tracking Number:

0920-1071-24AU

IC Status: Unchanged

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 and Instruction	0920-1071-24AU	TB Care Finder info requested to TB control programs PRA 10.23	TB Care Finder info requested to TB control programs PRA 10.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Human Subjects Determination	Human Subjects Determination.pdf	11/02/2023
Request for Approval	Service Delivery Fast Track Template TBCF_BR v2.docx	11/02/2023
TB-Care-Finder_Instructions_TB-Pgms_Hlth-Depts PRA 10.23	TB-Care-Finder_Instructions_TB-Pgms_Hlth-Depts PRA 10.23.docx	11/02/2023
TBCF Participant Invitation 10.23	TBCF Participant Invitation 10.23.docx	11/02/2023

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