Health Assessment of Persian Gulf War Veterans from Iowa

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
111108	Health Assessment of Persian Gulf War Veterans from Iowa	Migrated

ICR Details

OMB Control No: 0920-0371	ICR Reference No: 199506-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Health Assessment of Persian Gulf War Veterans from Iowa
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/19/1995
	Date Received in OIRA: 06/28/1995
Terms of Clearance: OMB approves the package contingent upon the modifications described in the correspondences of September 15 and 18, 1995. The changes were based on developing consistency with the precedent-setting VA National Health Survey of Persian Gulf War Era Veterans (OMB No. 2900-0558). In addition, to address potential bias related to survey length, CDC will continuously monitor respondent behavior for item non-response using the proposed CATI system. If monitoring reveals any signs of survey length bias, CDC will promptly notify OMB and will develop a plan to adjust for or otherwise address this bias. Finally, as proposed by CDC during the September 15 conference call, questions 72-82 will be deleted in the interest of time.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/1997	08/31/1997
Responses	3,150	0	0
Time Burden (Hours)	3,883	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The information obtained from this survey is needed in order to determine the prevalence of adverse health outcomes among Persian Gulf War veterans who listed Iowa as their home of record. The study will provide a scientific basis to assist CDC and other governmental agencies in determining the need and direction of future studies. A random sample of Persian Gulf War veterans will be compared with era controls.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Health Assessment of Persian Gulf War Veterans from Iowa

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ICR Summary of Burden

	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	3,150	0	0	3,150	0	0
Annual Time Burden (Hours)	3,883	0	0	3,883	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 06/28/1995

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