Information Collection

Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report

IC 199057 under ICR 201412-0920-014 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form CDC 43.50 Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report Form
CDC 43.50 122 CMRS -City Health Officers or Vital Statistics Regis Att Q_122 CMRS - city health officers or vital statistics registrars daily mortality report.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report	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	CDC 43.50	122 CMRS -City Health Officers or Vital Statistics Registrars Daily Mortality Report	Att Q_122 CMRS - city health officers or vital statistics registrars daily mortality report.pdf		Yes	Yes	Fillable Printable

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.