Information Collection

Advisory Council Report

IC 197697 under ICR 202509-0930-006 · OMB 0930-0169.

Documents and Forms

Document Name Document Type
Form PAIMI ACR Advisory Council Report Form and Instruction
Form PAIMI ACR PAIMI ACR Advisory Council Report Form and Instruction
PAIMI ACR PAIMI ACR FY2022_PAIMI_ACR_for_ OMB_ Approval_Packet.docx Form and Instruction
PAIMI ACR PAIMI ACR FY2022_PAIMI_ACR_for_ OMB_ Approval_Packet.docx Form and Instruction
Mark-up Copy 0169 PAIMI_ACR- 6.2.2023.docx PAIMI ACR _ Markup IC Document
Mark-up Copy 0169 PAIMI_ACR- 6.2.2023.docx PAIMI ACR _ Markup IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Advisory Council Report	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

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	PAIMI ACR	PAIMI ACR	FY2022_PAIMI_ACR_for_ OMB_ Approval_Packet.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	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	57	57
Annual IC Time Burden (Hours)	570	570
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PAIMI ACR _ Markup	Mark-up Copy 0169 PAIMI_ACR- 6.2.2023.docx	06/22/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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