View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

COVID-19 Vaccine Survey 2900-0876-AA2
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2900-0876-AA2-1 Yes Yes Fillable Fileable
Form and Instruction 2900-0876-AA2-2 Yes Yes Fillable Fileable
Form and Instruction 2900-0876-AA2-3 Yes Yes Fillable Fileable
Form and Instruction 2900-0876-AA2-4 Yes Yes Fillable Fileable

Health Immunization Management

 

15,000 0
   
Individuals or Households
 
   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 15,000 0 15,000 0 0 0
Annual IC Time Burden (Hours) 1,250 0 1,250 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
A-11 Fast-Track Clearance Request Template_COVID Vaccine 11/03/2020
COVID Vaccine Survey Sampling Plan 11/03/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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