ABCs Severe GAS Infection: Supplemental Form

[NCEZID] Emerging Infections Program

Documents and Forms

Document Name Document Type
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form Form and Instruction
Form ABC.100.4 ABCs Severe GAS Infection: Supplemental Form Form and Instruction
ABC.100.4 ABCs Severe GAS Infection: Supplemental Form ABC.100.4 ABCs Severe GAS Infection Supplemental Form.pdf Form and Instruction
ABC.100.4 ABCs Severe GAS Infection: Supplemental Form ABC.100.4 ABCs Severe GAS Infection Supplemental Form.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	ABCs Severe GAS Infection: Supplemental Form	Agency IC Tracking Number:	0920-0978

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

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	ABC.100.4	ABCs Severe GAS Infection: Supplemental Form	ABC.100.4 ABCs Severe GAS Infection Supplemental Form.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,360	1,360
Annual IC Time Burden (Hours)	453	453
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.