View Information Collection (IC)

View Information Collection (IC)

IC Title:	Assisted Reproductive Technology (ART) Program Reporting System	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Att C. NASS 2009 Screens V.2-3-09.pdf		Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 430	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

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	138,030	0	137,630	0	0	400
Annual IC Time Burden (Hours)	89,720	0	17,407	0	0	72,313
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Att C3. NASS previous questionnaire screen shot	Att C3. NASS PGD Screens.doc	07/01/2009
Att. C1 Annual submission instructions	Att C1. NASS Annual Submission Instructions.pdf	07/01/2009
Att. C2 NASS Users Manual	Att C2 NASS Users Manual.pdf	07/01/2009

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