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View Information Collection (IC)

STD/HIV Disease Intervention Specialist (DIS) Workforce Assessment 0920-0879-16AFI
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA NA Yes Yes Fillable Fileable

Health Health Care Services

 

499 0
   
State, Local, and Tribal Governments
 
   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 499 0 499 0 0 0
Annual IC Time Burden (Hours) 167 0 167 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
State Territorial and Local Health Departments List 05/04/2016
Notification Email 05/04/2016
Reminder Email 05/04/2016
Extension Email 05/04/2016
Instrument - WORD Version 05/04/2016
Supporting Statement A 05/04/2016
Supporting Statement B 05/04/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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