Information Collection

Harmful Algal Bloom-related Illness Surveillance System

IC 218236 under ICR 201701-0920-009 · OMB 0920-1105.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1105 can be found here:

Documents and Forms

Document Name Document Type
Harmful Algal Bloom-related Illness Surveillance System Form
Harmful Algal Bloom-related Illness Surveillance System Attachment_C_0920-xxxx Harmful Algal Bloom-related Illness Surveillance System (HABISS) DataDictionary.xlsx Form
0920-1105 OHHABS_DataDictionary_14Dec2016.xlsx Add Data Elements Dictionary IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Harmful Algal Bloom-related Illness Surveillance System	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	Harmful Algal Bloom-related Illness Surveillance System	Attachment_C_0920-xxxx Harmful Algal Bloom-related Illness Surveillance System (HABISS) DataDictionary.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	171	171
Annual IC Time Burden (Hours)	57	57
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Add Data Elements Dictionary	0920-1105 OHHABS_DataDictionary_14Dec2016.xlsx	01/26/2017

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