Information Collection

SDY Module N for State Health Personnel

IC 234894 under ICR 202508-0920-008 · OMB 0920-1092.

Documents and Forms

Document Name Document Type
Form 0920-1092 SDY Module N for State Health Personnel Form
Form 0920-1092 N SUID AND SDY CASE REGISTRY SDY Module N for State Health Personnel Form
0920-1092 N SUID AND SDY CASE REGISTRY Att 2c_NFR-CRS-SDY Module N updated 8-22-2025.docx Form
0920-1092 N SUID AND SDY CASE REGISTRY Att 2c_NFR-CRS-SDY Module N updated 8-22-2025.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SDY Module N for State Health Personnel	Agency IC Tracking Number:	0920-1092

Is this a Common Form? No		IC Status: Modified

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	0920-1092	N SUID AND SDY CASE REGISTRY	Att 2c_NFR-CRS-SDY Module N updated 8-22-2025.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	612	-103	715
Annual IC Time Burden (Hours)	102	-17	119
Annual IC Cost Burden (Dollars)	0	-2,252	2,252

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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].