View Information Collection (IC)

View Information Collection (IC)

IC Title:	Annual Reporting: Standards Evaluation Report (SER)	Agency IC Tracking Number:	0920-0573-24AD

Is this a Common Form? No		IC Status: Modified

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 and Instruction	0920-0573	2024 Standards Evaluation Report (SER) Surveillance Program Performance	Att3d SER PS18-1802_2024.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: SORN 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC	FR Citation: 57 FR 62812

Number of Respondents: 59	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	59	0	0	0	0	59
Annual IC Time Burden (Hours)	472	0	0	0	0	472
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Att 2_SER 2024 (track changes)	Att 2 SER PS18-1802_2024_track changes.docx	10/17/2023
Att 3d_ SER (WORD) rev.2024	Att 3d_SER (WORD)_rev. 2024.docx	10/17/2023

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