Information Collection

Annual Reporting: Standards Evaluation Report (SER)

IC 220109 under ICR 202602-0920-009 · OMB 0920-0573.

Documents and Forms

Document Name Document Type
Form 0920-0573 Standards Evaluation Report Annual Reporting: Standards Evaluation Report (SER) Form
0920-0573 Standards Evaluation Report Att_3d Standards Evaluation Report.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Annual Reporting: Standards Evaluation Report (SER)	Agency IC Tracking Number:	0920-0573

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	0920-0573	Standards Evaluation Report	Att_3d Standards Evaluation Report.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: SORN 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC	FR Citation: 57 FR 62812

Number of Respondents: 59	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	59	59
Annual IC Time Burden (Hours)	472	472
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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