Information Collection

VITAL-EQA Data Submission Form (Academic)

IC 255914 under ICR 202602-0920-004 · OMB 0920-1389.

Documents and Forms

Document Name Document Type
Data Submission Form Folate VITAL-EQA Data Submission Form (Academic) Form
Data Submission Form Vit B12 VITAL-EQA Data Submission Form (Academic) Form
Data Submission Form CRP VITAL-EQA Data Submission Form (Academic) Form
Data Submission Form Ferritin VITAL-EQA Data Submission Form (Academic) Form
Data Submission Form sTfR VITAL-EQA Data Submission Form (Academic) Form
Data Submission Form Vit D VITAL-EQA Data Submission Form (Academic) Form
Data Submission Form Vit A VITAL-EQA Data Submission Form (Academic) Form
Data Submission Form Folate Att3f-II VITAL-EQA Data Submission Form Folate.xlsx Form
Data Submission Form Vit B12 Att3f-II VITAL-EQA Data Submission Form Vit B12.xlsx Form
Data Submission Form CRP Att3f-II VITAL-EQA Data Submission Form CRP.xlsx Form
Data Submission Form Ferritin Att3f-II VITAL-EQA Data Submission Form Ferritin.xlsx Form
Data Submission Form sTfR Att3f-II VITAL-EQA Data Submission Form sTfR.xlsx Form
Data Submission Form Vit D Att3f-II VITAL-EQA Data Submission Form Vit D.xlsx Form
Data Submission Form Vit A Att3f-II VITAL-EQA Data Submission Form Vit A.xlsx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	VITAL-EQA Data Submission Form (Academic)	Agency IC Tracking Number:	0920-1389

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	n/a	Data Submission Form Folate	Att3f-II VITAL-EQA Data Submission Form Folate.xlsx	Yes	Yes	Fillable Fileable
Form	n/a	Data Submission Form Vit B12	Att3f-II VITAL-EQA Data Submission Form Vit B12.xlsx	Yes	Yes	Fillable Fileable
Form	n/a	Data Submission Form CRP	Att3f-II VITAL-EQA Data Submission Form CRP.xlsx	Yes	Yes	Fillable Fileable
Form	n/a	Data Submission Form Ferritin	Att3f-II VITAL-EQA Data Submission Form Ferritin.xlsx	Yes	Yes	Fillable Fileable
Form	n/a	Data Submission Form sTfR	Att3f-II VITAL-EQA Data Submission Form sTfR.xlsx	Yes	Yes	Fillable Fileable
Form	n/a	Data Submission Form Vit D	Att3f-II VITAL-EQA Data Submission Form Vit D.xlsx	Yes	Yes	Fillable Fileable
Form	n/a	Data Submission Form Vit A	Att3f-II VITAL-EQA Data Submission Form Vit A.xlsx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	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	60	60
Annual IC Time Burden (Hours)	45	45
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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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