Neiss

National Electronic Injury Surveillance System (NEISS) and Follow-up Activities for Product Related Injuries

Documents and Forms

Document Name Document Type
WebNEISS Data Entry Screen.PNG Other-WebNEISS Data Entry

Information Collection (IC) Details

IC Title:	NEISS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WebNEISS Data Entry			WebNEISS Data Entry Screen.PNG		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,084,053	0	1,084,053
Annual IC Time Burden (Hours)	115,000	-15,000	130,000
Annual IC Cost Burden (Dollars)	0	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.