OMB
.report
Search
Hhsar 311.71001(a) And 311.7202(b)
HHSAR 311.7101(a) and 311.7202(b)
OMB: 0990-0434
IC ID: 217361
OMB.report
HHS/HHSDM
OMB 0990-0434
ICR 201511-0990-004
IC 217361
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0434 can be found here:
2021-12-21 - Extension without change of a currently approved collection
2018-10-30 - 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:
HHSAR 311.71001(A) AND 311.7202(B)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
28 CFR Part 36 (To search for a specific CFR, visit the
Code of Federal Regulations.
)
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
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:
1,157
Number of Respondents for Small Entity:
0
Affected Public:
Federal Government
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
1,157
0
1,157
0
0
0
Annual IC Time Burden (Hours)
1,157
0
1,157
0
0
0
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.