Information Collection

Case Study of the Career Epidemiology Field Officer Assignments in Three State Health Department

IC 209499 under ICR 201110-0920-004 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Case Study of the Career Epidemiology Field Officer Assignments in Three State Health Department	Form and Instruction
Supervisor Interview CEFO ATTACHMENT B- Supervisor Instrument_11 21 13.docx	Form and Instruction
Partner Interview CEFO ATTACHMENT C- Partner Instrument_11 21 13.docx	Form and Instruction
CEFO ATTACHMENT D-Email Notification_11 21 13.docx D - Email Notification	IC Document
CEFO ATTACHMENT A- Field Assignments Map 11 18 13.pdf A - Map of Field Assignments	IC Document
CEFO ATTACHMENT E- Email Reminder 11 21 13.docx E - Email Reminder	IC Document
CEFO Supporting Statement A_ 11 21 13.docx Supporting Statement A	IC Document
CEFO Supporting Statement B_11 21 13.docx Supporting Statement B	IC Document

IC Title:

Case Study of the Career Epidemiology Field Officer Assignments in Three State Health Department

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	none	Supervisor Interview	CEFO ATTACHMENT B- Supervisor Instrument_11 21 13.docx		No	No	Printable Only
Form and Instruction	none	Partner Interview	CEFO ATTACHMENT C- Partner Instrument_11 21 13.docx		No	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 18

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	18	0	0	0	0	0
Annual IC Time Burden (Hours)	15	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
D - Email Notification	CEFO ATTACHMENT D-Email Notification_11 21 13.docx	11/21/2013
A - Map of Field Assignments	CEFO ATTACHMENT A- Field Assignments Map 11 18 13.pdf	11/20/2013
E - Email Reminder	CEFO ATTACHMENT E- Email Reminder 11 21 13.docx	11/21/2013
Supporting Statement A	CEFO Supporting Statement A_ 11 21 13.docx	11/21/2013
Supporting Statement B	CEFO Supporting Statement B_11 21 13.docx	11/21/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.