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Monthly Vital Statistics Report Forms
MONTHLY VITAL STATISTICS REPORT FORMS
OMB: 0920-0213
IC ID: 110874
OMB.report
HHS/CDC
OMB 0920-0213
ICR 198802-0920-007
IC 110874
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0213 can be found here:
2022-05-17 - Revision of a currently approved collection
2020-08-24 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
MONTHLY VITAL STATISTICS REPORT FORMS
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
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
PHS-6275
No
No
Form
6275A
No
No
Form
6275B, C
No
No
Form
D
No
No
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
164
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
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
1,968
0
0
1,968
0
0
Annual IC Time Burden (Hours)
197
0
0
197
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.