OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Symptom survey

IC 240024 under ICR 202503-0920-004 · OMB 0920-1316.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Symptom survey 0920-1316
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-1316 Symptom survey Att7 Symptom Survey 20200212.docx Yes Yes Fillable Fileable
Form 0920-1316 Symptom Survey - Revised 10JUL2023 0929-1316 Change Request Att7 Symptom Survey 06212023 FINAL.docx NA Yes Yes Fillable Fileable

Health Consumer Health and Safety

Epidemiologic studies and surveillance of disease problems.  57 FR 62812

67 0
   
Individuals or Households
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 670 0 0 0 0 670
Annual IC Time Burden (Hours) 168 0 0 0 0 168
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.