Information Collection

AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae

IC 258566 under ICR 202602-0920-013 · OMB 0920-1310.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae (SHARP) AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae	Form and Instruction
AR Lab Network Alert and Monthly Data Report Form for Ne Attachment 3f_AR Lab Network Alert and Monthly Data Report Form for Neisseria gonorrhoeae_final.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Mandatory

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 and Instruction	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: 17

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	Previously Approved
Annual Number of Responses for this IC	1,581	1,581
Annual IC Time Burden (Hours)	158	158
Annual IC Cost Burden (Dollars)	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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