Information Collection

Tribal Nations - One-time addition of Diseases and Data Elements

IC 283137 under ICR 202609-0920-007 · OMB 0920-0728.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 6 Core Data.xlsx	Instruction
Att 7 Laboratory Data.xlsx	Instruction
Att 8 Vaccine Data.xlsx	Instruction
Att 9 Vaccine Preventable Disease Data.xlsx	Instruction
Att 11 Disease-Specific Data.xlsx	Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	N/A	Yes	Yes	Fillable Fileable
Instruction	N/A	Yes	Yes	Fillable Fileable
Instruction	N/A	Yes	Yes	Fillable Fileable
Instruction	N/A	Yes	Yes	Fillable Fileable
Instruction	N/A	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Epidemiologic Studies and Surveillance of Disease Problems

FR Citation: 76 FR 4458

Number of Respondents: 50

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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	100	100
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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