Information Collection

Data Validation Description

IC 232351 under ICR 202412-0920-017 · OMB 0920-0556.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AttachmentsAtt H. Validation Description.docx	Instruction
AttachmentsAtt H. Validation Description.docx	Instruction

IC Title:

Agency IC Tracking Number:

0920-0556

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
Instruction					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 57 FR 82612

Number of Respondents: 35

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	Previously Approved
Annual Number of Responses for this IC	2,450	2,450
Annual IC Time Burden (Hours)	939	939
Annual IC Cost Burden (Dollars)	43,201	43,201

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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