Information Collection

Routine Testing Results

IC 192291 under ICR 202602-0920-006 · OMB 0920-0850.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0850 Routine Testing Data Elements Routine Testing Results	Form
0920-0850 Routine Testing Data Elements Att 3b_Routine Testing Data Elements.docx	Form

IC Title:

Agency IC Tracking Number:

0920-0850

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	0920-0850				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 136

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	3,400	3,270	130
Annual IC Time Burden (Hours)	1,700	1,440	260
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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