Information Collection

Donor

IC 43644 under ICR 202601-0930-002 · OMB 0930-0158.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2026 FedCCF_Proof 2026 FedCCF_Proof Donor	Form and Instruction
2026 FedCCF_Proof 2026 FedCCF_Proof Att I 2026_FedCCF_PROOF_250729.pdf	Form and Instruction
Att D Executive Order_12564.pdf CCF Executive Orders - 12564	IC Document
Att F UrMG_12Oct2023_2023-21734.pdf 2026 CCF UrMG	IC Document

IC Title:

Donor

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	2026 FedCCF_Proof				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,726,610

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	6,726,610	6,726,610
Annual IC Time Burden (Hours)	538,129	538,129
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CCF Executive Orders - 12564		01/13/2026
2026 CCF UrMG		01/13/2026

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

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