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2009 Flu Prevention Public Service Announcement Contest Form
2009 Flu Prevention Public Service Announcement Contest Form
OMB: 0990-0338
IC ID: 189892
OMB.report
HHS/HHSDM
OMB 0990-0338
ICR 200907-0990-001
IC 189892
( )
Documents and Forms
Document Name
Document Type
Form 1
2009 Flu Prevention Public Service Announcement Contest Form
Form
1 2009 Flu Prevention PSA Contest Form
Emergency 2009 Flu Prevention PSA Contest Form 7.13.2009.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
2009 Flu Prevention Public Service Announcement Contest Form
Agency IC Tracking Number:
Is this a Common Form?
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
1
2009 Flu Prevention PSA Contest Form
Emergency 2009 Flu Prevention PSA Contest Form 7.13.2009.doc
Yes
Yes
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
300
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
300
0
300
0
0
0
Annual IC Time Burden (Hours)
30
0
30
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
