Information Collection

42 Cfr 2.31; 2.52; 2.53

IC 242313 under ICR 202006-0930-002 · OMB 0930-0092.

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Information Collection (IC) Details

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IC Title:	42 CFR 2.31; 2.52; 2.53	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 2.31 Consent Requirements 42 CFR 2.52 Research 42 CFR 2.53 Audit and Evaluation

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,585	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	248,741	248,741
Annual IC Time Burden (Hours)	155,463	155,463
Annual IC Cost Burden (Dollars)	6,964,748	6,964,748

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