View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	HIV Surveillance Data System Needs and IT Capability Assessment	Agency IC Tracking Number:	0920-21BP

IC Status: New

Obligation to Respond: Voluntary

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	n/a	HIV Surveillance System and IT Capability Survey	Questions_HIV Surveillance Data System Needs and IT Capability_20201216.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

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	59	0	0	0
Annual IC Time Burden (Hours)	118	0	118	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
GENIC Template with Project Description	Generic Clearance_HIV Surveillance Data System Needs and IT Capability Assessment.docx	12/18/2020

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