Information Collection

Qualified Participants (Testing) Phase 3

IC 196086 under ICR 201405-0920-001 · OMB 0920-0888.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0888 can be found here:

Documents and Forms

Document Name Document Type
Suppl_3-flyer_Phase_3_Influenza(10GX)_May_2011[1].docx Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Qualified Participants (Testing) Phase 3	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Suppl_3-flyer_Phase_3_Influenza(10GX)_May_2011[1].docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-40	40
Annual IC Time Burden (Hours)	-17	17
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.