Information Collection

SUPRT-Admin

IC 272852 under ICR 202502-0930-001 · OMB 0930-0400.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0400 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SUPRT- Administrat SUPRT-Admin	Form and Instruction
Form SUPRT- Administrat SUPRT- Administrative Level Tool SUPRT-Admin	Form and Instruction
SUPRT- Administrat SUPRT- Administrative Level Tool SUPRT-Administrative-Clean.docx	Form and Instruction
SUPRT- Administrat SUPRT- Administrative Level Tool SUPRT-Administrative-Clean.docx	Form and Instruction

IC Title:

SUPRT-Admin

Agency IC Tracking Number:

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 and Instruction	SUPRT- Administrative Level Tool				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: SUPRT-Admin

FR Citation: 75 FR 28264

Number of Respondents: 2,125

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,787,125	1,787,125
Annual IC Time Burden (Hours)	431,269	431,269
Annual IC Cost Burden (Dollars)	0	0

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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