Information Collection

Molecular Mtb Testing- Annual Evaluation and Performance Measurement Report

IC 271455 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⚠️ Notice: This information collection may be referencing outdated material.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 I15 Molecular Mtb Testing- Annual Evaluation and Performance Measurement Report	Form and Instruction
Form I15 Molecular Mtb Testing Molecular Mtb Testing- Annual Evaluation and Performance Measurement Report	Form and Instruction
I15 Molecular Mtb Testing Attachment 2o_I.15- MOLECULAR Mtb TESTING- Annual Evaluation and Performance Measurement Report_final.docx	Form and Instruction
I15 Molecular Mtb Testing Attachment 2o_I.15- MOLECULAR Mtb TESTING- Annual Evaluation and Performance Measurement Report_final.docx	Form and Instruction

IC Title:

Molecular Mtb Testing- Annual Evaluation and Performance Measurement Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	I15				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

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	20	20
Annual IC Time Burden (Hours)	3	3
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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