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View Information Collection (IC)

[CSTLTS] Disease Intervention Specialist (DIS) Workforce Assessment 0920-0879-23CX
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0879 Yes Yes Fillable Fileable
Form and Instruction 0920-0879 Yes Yes Fillable Fileable

Health Public Health Monitoring

 

491 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 491 0 491 0 0 0
Annual IC Time Burden (Hours) 985 0 985 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A 03/01/2023
Supporting Statement B 03/01/2023
Att A_State, Territorial, and Local Health Departments 03/03/2023
Att B_Instrument State and Territorial Word Version 03/03/2023
Att D_Instrument Local Word Version 03/03/2023
Att F_State and Territorial Notification Email 03/03/2023
Att G_State and Territorial Reminder Email 03/03/2023
Att G_State and Territorial Extension Email 03/03/2023
Att I_ Local Notification Email 03/03/2023
Att J_Local Reminder Email 03/03/2023
Att K_ Local Extension Email 03/03/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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