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24-Hour Urine Collection
Salt Sources Study
OMB: 0920-0982
IC ID: 207198
OMB.report
HHS/CDC
OMB 0920-0982
ICR 201401-0920-004
IC 207198
( )
Documents and Forms
Document Name
Document Type
24-Hour Urine Collection
Form
24-hour Urine Collection
Att 15A_24hr Urine Collection Form_01082014.doc
Form
Att 15B_24 Hour Urine Collection Instructions_01082014.docx
Att 15B_24 Hour Urine Collection Instructions_01082014
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
24-Hour Urine Collection
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
Form
none
24-hour Urine Collection
Att 15A_24hr Urine Collection Form_01082014.doc
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
57 FR 252
Number of Respondents:
75
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
300
0
0
0
0
300
Annual IC Time Burden (Hours)
250
0
0
0
0
250
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 15B_24 Hour Urine Collection Instructions_01082014
Att 15B_24 Hour Urine Collection Instructions_01082014.docx
01/09/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.