Information Collection

MPV Micronutrients MBA Data Submission Form (International)

IC 255935 under ICR 202602-0920-004 · OMB 0920-1389.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
MPV Micronutrients MBA Enrollment Section on Data Submission Form MPV Micronutrients MBA Data Submission Form (International)	Form
MPV Micronutrients MBA Enrollment Section on Data Submis Att 3h. MPVMicro Enroll&DataReturn.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: 15

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	15	-65	80
Annual IC Time Burden (Hours)	23	-37	60
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.

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