Information Collection

Grantee-Level Instrument

IC 234465 under ICR 201812-0930-001 · OMB 0930-0384.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0384 can be found here:

Documents and Forms

Document Name Document Type
Form Grantee-Level Inst Grantee-Level Instrument Form and Instruction
Grantee-Level Inst Grantee-Level Instrument Attachment C - SOR TOR Program Instrument.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Grantee-Level Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	Grantee-Level Instrument	Grantee-Level Instrument	Attachment C - SOR TOR Program Instrument.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 359	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,436	1,436
Annual IC Time Burden (Hours)	244	244
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.