Information Collection

TB Indicators REDCap web form

IC 218237 under ICR 202408-0920-009 · OMB 0920-1102.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1102 TB Indicators REDCap web form	Form
Form 0920-1102 Tuberculosis Indicators TB Indicators REDCap web form	Form
0920-1102 Tuberculosis Indicators Attachment B-TB Indicators REDCap Web Form.docx	Form
0920-1102 Tuberculosis Indicators Attachment B-TB Indicators REDCap Web Form.docx	Form

IC Title:

Agency IC Tracking Number:

0920-1102

Is this a Common Form? No

IC Status: Modified

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	0920-1102				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 333

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	333	0	333
Annual IC Time Burden (Hours)	999	0	999
Annual IC Cost Burden (Dollars)	0	-105,115	105,115

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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