Information Collection

MPV Folate MBA Data Submission Form (International)

IC 255926 under ICR 202602-0920-004 · OMB 0920-1389.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
MPV Folate MBA Enrollment Section on Data Submission Form MPV Folate MBA Data Submission Form (International)	Form
MPV Folate MBA Enrollment Section on Data Submission For Att3g MPV Folate MBA Enrollment and Data Submission Form_final.xlsx	Form

IC Title:

Agency IC Tracking Number:

0920-1389

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	n/a				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	10	-50	60
Annual IC Time Burden (Hours)	15	-30	45
Annual IC Cost Burden (Dollars)	0	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.

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].