Att 3b_Component 2: Core Viral Hepatitis Prevention Activities

[NCCHSTP] Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments

Documents and Forms

Document Name Document Type
Form 0920-1353 Att 3b_Component 2: Core Viral Hepatitis Prevention Activities Form
0920-1353 Component 2: Core Viral Hepatitis Prevention Activities Att 3b_Comp 2_APR_Form_rev.2024.docx Form
0920-1353 Component 2: Core Viral Hepatitis Prevention Activities Att 3b_Comp 2_APR_Form_rev.2024.docx Form
Att5b_Comp 2 Instructions.docx Annual Performance Report—Component 2--Form Instructions Year 3 Reporting Period (10/1/22-9/30/23) IC Document
Att5b_Comp 2 Instructions.docx Annual Performance Report—Component 2--Form Instructions Year 3 Reporting Period (10/1/22-9/30/23) IC Document

Information Collection (IC) Details

IC Title:	Att 3b_Component 2: Core Viral Hepatitis Prevention Activities	Agency IC Tracking Number:	0920-1353

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-1353	Component 2: Core Viral Hepatitis Prevention Activities	Att 3b_Comp 2_APR_Form_rev.2024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 59	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	59	0	59
Annual IC Time Burden (Hours)	69	10	59
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Annual Performance Report—Component 2--Form Instructions Year 3 Reporting Period (10/1/22-9/30/23)	Att5b_Comp 2 Instructions.docx	03/22/2024

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