Information Collection

CMRS Daily - City Health Officer or Vital Statistics Registrars

IC 199057 under ICR 201401-0920-001 · OMB 0920-0004.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0004 can be found here:

Documents and Forms

Document Name Document Type
CMRS Daily - City Health Officer or Vital Statistics Registrars Form
CMRS Daily 122 CMRS daily mortality form.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CMRS Daily - City Health Officer or Vital Statistics Registrars	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	CMRS Daily	122 CMRS daily mortality form.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 58	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 62 %

	Approved	Previously Approved
Annual Number of Responses for this IC	21,170	21,170
Annual IC Time Burden (Hours)	4,234	4,234
Annual IC Cost Burden (Dollars)	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.