Information Collection

Routine Testing by Genera in Jurisdiction- Annual Evaluation and Performance Measurement Report

IC 271433 under ICR 202512-0920-010 · OMB 0920-1310.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1310 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I1 Routine Testing by Genera in Jurisdiction- Annual Evaluation and Performance Measurement Report	Form and Instruction
Form I1 Routine Testing by Genus in Jurisdiction Routine Testing by Genera in Jurisdiction- Annual Evaluation and Performance Measurement Report	Form and Instruction
I1 Routine Testing by Genus in Jurisdiction Attachment 2a_I.1 – ROUTINE TESTING BY GENERA IN JURISDICTION- AEPMR.docx	Form and Instruction
I1 Routine Testing by Genus in Jurisdiction Attachment 2a_I.1 – ROUTINE TESTING BY GENERA IN JURISDICTION- AEPMR.docx	Form and Instruction

IC Title:

Routine Testing by Genera in Jurisdiction- Annual Evaluation and Performance Measurement Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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	I1				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 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	57	57
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	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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