MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Enrollment Form

CDC Model Performance Evaluation Program (MPEP) for Mycobacterium tuberculosis and Nontuberculous Mycobacteria Drug Susceptibility Testing

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0600 can be found here:

Documents and Forms

Document Name Document Type
MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Enrollment Form Form
Enrollment form 0920-0600 Attachment 3a Enrollment Form (2).doc Form
0920-0600 Attachment 3b Program Description.doc Program description IC Document
0920-0600 Attachment 3c Acceptance Letter Template.doc Acceptance letter IC Document

Information Collection (IC) Details

IC Title:	MPEP for M. TB and non-tuberculous Mycobacteria Drug Susceptibility Testing Enrollment Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	none	Enrollment form	0920-0600 Attachment 3a Enrollment Form (2).doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-4	4
Annual IC Time Burden (Hours)	-1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Program description	0920-0600 Attachment 3b Program Description.doc	12/16/2009
Acceptance letter	0920-0600 Attachment 3c Acceptance Letter Template.doc	12/16/2009

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