Information Collection

Adenovirus Typing Report Form

IC 212472 under ICR 202512-0920-005 · OMB 0920-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0004 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-26-0003 Adenovirus Typing Report Form	Form
Form 0920-26-0003 National Adenovirus Type Reporting System (NATRS) Form Adenovirus Typing Report Form	Form
0920-26-0003 National Adenovirus Type Reporting System (NATRS) Form AdenovirusSurveillanceForm_ver7.0_final .xlsx	Form
0920-26-0003 National Adenovirus Type Reporting System (NATRS) Form AdenovirusSurveillanceForm_ver7.0_final .xlsx	Form
NATRS_DataDictionary_8.2022_ct.xlsx Data Dictionary	IC Document
NATRS_DataDictionary_8.2022_ct.xlsx Data Dictionary	IC Document

IC Title:

Adenovirus Typing Report Form

Agency IC Tracking Number:

0920-26-0003

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	0920-26-0003			NA	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13

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	Previously Approved
Annual Number of Responses for this IC	52	52
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Data Dictionary		12/08/2025

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].