Information Collection

Basic level awardees - Initial MIS population

IC 178975 under ICR 201708-0920-005 · OMB 0920-0739.

Documents and Forms

Document Name Document Type
Basic level awardees - Initial MIS population Form
Chronic Disease MIS Att 5. MIS Screen Shots.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Basic level awardees - Initial MIS population	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Chronic Disease MIS	Att 5. MIS Screen Shots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-1	1
Annual IC Time Burden (Hours)	-6	6
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.