Information Collection

Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)

IC 211907 under ICR 201111-0920-003 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)	Form
Screener in English and Spanish ATTACHMENT_D-Participant_Screening_Instrument.docx	Form
Dicussion Guide in English and Spanish ATTACHMENT_C-Discussion_Guide.docx	Form
ATTACHMENT_E-Participant_Information_Sheet.docx Participant Information Sheet	IC Document
ATTACHMENT_F-Breaking_News_Script.docx News Script	IC Document
ATTACHMENT_G_Materials_for_Testing.pptx Materials for Testing	IC Document
ATTACHMENT_B-Full_Protocol.docx Full Protocol	IC Document
ATTACHMENT_A-Protocol_Summary.docx Protocol Summary	IC Document
Anthrax Materials-HMTS Expedited Review Form_508 compliant-signed.pdf Expedited Review Form	IC Document

IC Title:

Evaluation of Emergency Preparedness Materials for Limited English Proficient Spanish-Speakers (14AHO)

Agency IC Tracking Number:

14AHO

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	none	Screener in English and Spanish	ATTACHMENT_D-Participant_Screening_Instrument.docx		No		Paper Only
Form	none	Dicussion Guide in English and Spanish	ATTACHMENT_C-Discussion_Guide.docx		No		Paper Only

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 450

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 Agency Discretion
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	351	351
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Participant Information Sheet	ATTACHMENT_E-Participant_Information_Sheet.docx	06/16/2014
News Script	ATTACHMENT_F-Breaking_News_Script.docx	06/16/2014
Materials for Testing	ATTACHMENT_G_Materials_for_Testing.pptx	06/16/2014
Full Protocol	ATTACHMENT_B-Full_Protocol.docx	06/16/2014
Protocol Summary	ATTACHMENT_A-Protocol_Summary.docx	06/16/2014
Expedited Review Form	Anthrax Materials-HMTS Expedited Review Form_508 compliant-signed.pdf	06/16/2014

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