Information Collection

Component 3 - STLT Health Dept Case Data

IC 263102 under ICR 202609-0920-006 · OMB 0920-1422.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment-10_Component-3_NWSS_DCIPHER_CaseData_CSV_Upload_Template.csv	Other-Template
Attachment-11_Component-3_NWSS_DCIPHER_SewershedName_Crosswalk_CSV_Upload_Template.csv	Other-Template
Attachment-07_Component-1-2-3_ref-NWSS_DCIPHER_BulkUploadTool_screenshot.pdf NWSS Bulk Upload Tool - screenshot	IC Document
Attachment-08_Component-3_ref-NWSS COVID Case Data Dictionary_v1_0_0.xlsx NWSS COVID Case Data Dictionary	IC Document

IC Title:

Agency IC Tracking Number:

0920-23GL

Is this a Common Form? No

IC Status: Removed

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
Other-Template					Yes	Yes	Fillable Fileable
Other-Template					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 55

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
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-3,664,595	3,664,595
Annual IC Time Burden (Hours)	-305,383	305,383
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NWSS Bulk Upload Tool - screenshot		10/30/2023
NWSS COVID Case Data Dictionary		10/30/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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