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Federal forms, ICRs, and supporting documents

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Cluster Follow-up Report

IC 236511 under ICR 202602-0920-009 · OMB 0920-0573.

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Document Name
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Cluster Follow-up Report 0920-0573
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0573 Follow-up Cluster Report Form Att_3f Follow-up Cluster Report Form.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

SORN 09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems HHS/CDC  57 FR 62812

59 0
   
State, Local, and Tribal Governments
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 295 0 0 0 0 295
Annual IC Time Burden (Hours) 148 0 0 0 0 148
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Instructions for Completing the Cluster Report Att_4(f) Cluster Report Form Instructions updated 11052021_share.pdf 09/08/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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