Information Collection Request

Registration of Individuals Displaced by Hurricanes Katrina and Rita (Pilot Project)

ICR 201211-0923-001 · OMB 0923-0045 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Katrina and Rita Exposures Registry - questionnaire Form and Instruction Modified Available
Screener Form and Instruction Modified Available
Supporting Statement B Katrina Registry 20130122.doc Supporting Statement B Uploaded 2013-02-06 Available
Appendix O Propose Billboards 20121101.pdf Supplementary Document Uploaded 2012-11-14 Available
Appendix N KARE Brochure 20130204.pdf Supplementary Document Uploaded 2013-02-06 Available
Appendix M Reminder_Postcard 20130125.doc Supplementary Document Uploaded 2013-02-06 Available
Appendix L Outreach_Website_Contents_FAQs 2130130.docx Supplementary Document Uploaded 2013-02-06 Available
Appendix K Outreach Plan Outline 20121101.docx Supplementary Document Uploaded 2012-11-14 Available
Appendix J Power Calculations 20121101.doc Supplementary Document Uploaded 2012-11-14 Available
Appendix I Sampling Plan 20121101.docx Supplementary Document Uploaded 2012-11-14 Available
Appendix G IRB Approval Letter 20120905.docx Supplementary Document Uploaded 2012-11-14 Available
Appendix D Letter of Intro 20121101.docx Supplementary Document Uploaded 2012-11-14 Available
Appendix C Access Controls 20121101.doc Supplementary Document Uploaded 2012-11-14 Available
Appendix A Authorizing Legislation 20121101.doc Supplementary Document Uploaded 2012-11-14 Available
Appendix B 60-day FRN 20090413.pdf Supplementary Document Uploaded 2012-11-14 Available
Supporting Statement A Katrina Registry 20130204.docx Supporting Statement A Uploaded 2013-02-06 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
201175 Katrina and Rita Exposures Registry - questionnaire Form and Instruction Modified
201174 Screener Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/29/2016 24 Months From Approved
4,000 0 0
533 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Screener none, none Screener
Katrina and Rita Exposures Registry - questionnaire none Quesitonaire

table that charts list 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 4,000 0 0 4,000 0 0
Annual Time Burden (Hours) 533 0 0 533 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No