Information Collection

School Dismissal Monitoring System (Reporting Form)

IC 192337 under ICR 201304-0920-009 · OMB 0920-0849.

Documents and Forms

Document Name Document Type
School Dismissal Monitoring System (Reporting Form) Form
School Dismissal Monitoring Sysem Attachment 4 SDMS reporting form_screenshot_final.docx Form
Attachment 3 CDC School Guidance.pdf Attachment 3 CDC School Guidance IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	School Dismissal Monitoring System (Reporting Form)	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	School Dismissal Monitoring Sysem	Attachment 4 SDMS reporting form_screenshot_final.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,500	Number of Respondents for Small Entity: 100

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	2,500	2,000	500
Annual IC Time Burden (Hours)	208	166	42
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 3 CDC School Guidance	Attachment 3 CDC School Guidance.pdf	02/24/2010

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