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Federal forms, ICRs, and supporting documents

Information Collection

(Passenger) 72-hour Food/Activity History Template (AGE cases)

IC 252607 under ICR 202204-0920-002 · OMB 0920-1260.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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(Passenger) 72-hour Food/Activity History Template (AGE cases) 0920-1260
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1260 72-hour Food/Activity History Template (AGE cases) Att5c 72-hrFoodActivityHistoryForm 20220125.docx Yes Yes Fillable Fileable

Health Illness Prevention

 

83,850 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 83,850 0 66,600 17,250 0 0
Annual IC Time Burden (Hours) 13,975 0 11,100 2,875 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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