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State and Local Health Dept Surveillance for Childhood National Blood Lead Surveillance System
National Blood Lead Surveillance
OMB: 0920-0337
IC ID: 6764
OMB.report
HHS/CDC
OMB 0920-0337
ICR 200805-0920-008
IC 6764
( )
Documents and Forms
Document Name
Document Type
Appendix_3.datafields.doc
Other-Database submission
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State and Local Health Dept Surveillance for Childhood National Blood Lead Surveillance System
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Other-Database submission
Appendix_3.datafields.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
42
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
168
0
-168
0
0
336
Annual IC Time Burden (Hours)
336
0
-336
0
0
672
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.