Information Collection

TTA Event Description Form

IC 252646 under ICR 202505-0930-005 · OMB 0930-0389.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form TTA Event Descript TTA Event Description Form	Form and Instruction
Form TTA Event Descript TTA Event Description Form TTA Event Description Form	Form and Instruction
TTA Event Descript TTA Event Description Form Attachment 1_TTA Event Description Form_1-10-2022.docx	Form and Instruction
TTA Event Descript TTA Event Description Form Attachment 1_TTA Event Description Form_1-10-2022.docx	Form and Instruction

IC Title:

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	TTA Event Description Form				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: TTA Event Description Form

FR Citation: 75 FR 28264

Number of Respondents: 113

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
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,424	3,424	2,000
Annual IC Time Burden (Hours)	868	548	320
Annual IC Cost Burden (Dollars)	0	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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