GUILLAIN-BARRE SYNDROME SURVEILLANCE

ICR 197912-0920-001

OMB: 0920-0036

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
110638 Migrated
ICR Details
0920-0036 197912-0920-001
Historical Active 197711-0920-001
HHS/CDC
GUILLAIN-BARRE SYNDROME SURVEILLANCE
Revision of a currently approved collection   No
Regular
Approved without change 12/27/1979
Retrieve Notice of Action (NOA) 12/06/1979
  Inventory as of this Action Requested Previously Approved
12/31/1982 12/31/1982 12/31/1979
1,000 0 1,000
167 0 167
0 0 0

TO DETERMINE THE EPIDEMIOLOGIC CHARACTERISTICS OF GUILLAIN-BARRE SYNDROME SURVEILLANCE; IN PARTICULAR ITS ASSOCIATION WITH INFLUENZA VACCINE.

None
None


No

1
IC Title Form No. Form Name
GUILLAIN-BARRE SYNDROME SURVEILLANCE CDC 4.565A

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,000 1,000 0 0 0 0
Annual Time Burden (Hours) 167 167 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/06/1979


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