Information Collection

Bagged Salad and Cyclospora

IC 208219 under ICR 201106-0910-007 · OMB 0910-0711.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cyclospora and Bagged Salad Screener.doc	Other-Interview Screening Instrument
Cyclospora and Bagged Salad Questionnairre.doc	Other-Survey
Cyclospora and Bagged Salad Survey Clearance Request.doc	Other-Generic Clearance Justificatio

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Interview Screening Instrument	Yes	Yes	Fillable Fileable
Other-Survey	Yes	Yes	Fillable Fileable
Other-Generic Clearance Justification Memo	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	10,000	0	0	0	0	0
Annual IC Time Burden (Hours)	1,725	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
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.

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