Minimum Data Elements/System for Technical Assistance Reporting for the National Breast and Cervical Cancer Early Detection Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0571 can be found here:

Documents and Forms

Document Name Document Type
MDEs_STAR Draft_Attachment 03b.doc Instruction
Part2worksheet.doc Part2worksheet IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Minimum Data Elements/System for Technical Assistance Reporting for the National Breast and Cervical Cancer Early Detection Program	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			MDEs_STAR Draft_Attachment 03b.doc		Yes	No	Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 68	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 Agency Discretion	Previously Approved
Annual Number of Responses for this IC	68	-205	273
Annual IC Time Burden (Hours)	1,700	-643	2,343
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Part2worksheet	Part2worksheet.doc	11/14/2006

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