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Online Survey Instrument
CDC Model Performance Evaluation Program (MPEP) for Mycobacterium tuberculosis and Nontuberculous Mycobacteria Drug Susceptibility Testing
OMB: 0920-0600
IC ID: 192388
OMB.report
HHS/CDC
OMB 0920-0600
ICR 201601-0920-019
IC 192388
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0600 can be found here:
2021-12-15 - Revision of a currently approved collection
2019-01-08 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Online Survey Instrument
Form
Survey Screenshots
Att C Survey Instrument Web Shots.pdf
Form
Survey Instrument Changes.docx
Survey Instrument Changes
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Online Survey Instrument
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
Survey Screenshots
Att C Survey Instrument Web Shots.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
93
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
186
0
0
0
0
186
Annual IC Time Burden (Hours)
47
0
0
0
0
47
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Survey Instrument Changes
Survey Instrument Changes.docx
11/07/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.