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

View Information Collection (IC)

[PHIC] OT21-2103 Success Stories (2024-2026) 0920-0879-24ET
 
Unchanged
 
Voluntary
 

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

Health Public Health Monitoring

 

108 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested 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 2,160 0 0 0 0 2,160
Annual IC Time Burden (Hours) 13,320 0 0 0 0 13,320
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Recipient List 04/18/2024
OT20-2103 Success Stories Form - Screenshots 04/18/2024
Guidance Document 04/18/2024
Email Announcement and Invitation 04/18/2024
Reminder Email 04/18/2024
SSA 04/18/2024
SSB 04/18/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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