View Information Collection (IC)

View Information Collection (IC)

IC Title:	NPCR-CSS Standard Data Items Collected	Agency IC Tracking Number:	0920-0469

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			0469 Att 3a Data Items Diagnosis Year 1995-2020.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0160, Records of Subjects in Health Promotion and Education Studies	FR Citation: 51 FR 42484

Number of Respondents: 50	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	100	0	0	0	0	100
Annual IC Time Burden (Hours)	200	0	0	0	0	200
Annual IC Cost Burden (Dollars)	7,200	0	7,200	0	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Burden Statement on the NPCR-CSS Website	0469 Att 9 OMB Burden Statement on NPCR CSS Website.pdf	05/09/2022

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