Antifungal Resistant Tinea Dermatophytes - Annual Evaluation and Performance Measurement Report

[NCEZID] Public Health Laboratory Testing for Emerging Antibiotic Resistance and Fungal Threats

Documents and Forms

Document Name Document Type
Form I12 Antifungal Resistant Tinea Dermatophytes - Annual Evaluation and Performance Measurement Report Form and Instruction
I12 Antifungal Resistant Tinea/Dermatophytes Attachment 2l_I.12- ANTIFUNGAL RESISTANT TINEA DERMATOPHYTES -AEPMR.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Antifungal Resistant Tinea Dermatophytes - Annual Evaluation and Performance Measurement Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	I12	Antifungal Resistant Tinea/Dermatophytes	Attachment 2l_I.12- ANTIFUNGAL RESISTANT TINEA DERMATOPHYTES -AEPMR.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3	3
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.