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School Participation Form
[NCCDPHP] Oral Health Basic Screening Survey for Children
OMB: 0920-1346
IC ID: 245499
OMB.report
HHS/CDC
OMB 0920-1346
ICR 202408-0920-007
IC 245499
( )
Documents and Forms
Document Name
Document Type
School Participation Form
Form and Instruction
School Participation Form
2d_invitation to schools.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
School Participation Form
Agency IC Tracking Number:
0920-1346
Is this a Common Form?
Yes
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
n/a
School Participation Form
2d_invitation to schools.docx
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:
2,890
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
2,890
0
0
0
0
2,890
Annual IC Time Burden (Hours)
3,275
0
0
0
0
3,275
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.