Privacy Act and Public Burden Information
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Form Approved
OMB No. 0920-0765
Exp. Date 2/15/2011
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Public reporting burden of this collection of information varies from 15 to 40 minutes
with an estimated average of 30 minutes per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may
not conduct or sponsor, and a person is not required to respond to a collection
of information unless it displays a currently valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer;
1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0765).
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