Information Collection

C. Auris Colonization Screening in Jurisdiction-Annual Evaluation and Performance Measurement Report

IC 271440 under ICR 202602-0920-013 · OMB 0920-1310.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form I5 C. Auris Colonization Screening in Jurisdiction C. Auris Colonization Screening in Jurisdiction-Annual Evaluation and Performance Measurement Report	Form and Instruction
I5 C. Auris Colonization Screening in Jurisdiction Attachment 2e_I.5- C. AURIS COLONIZATION SCREENING IN JURISDICTION-AEPMR.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	I5				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 57

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	57	57
Annual IC Time Burden (Hours)	10	10
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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