Information Collection

Organizers Survey

IC 182093 under ICR 201309-0930-001 · OMB 0930-0288.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0288 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Organizer Survey Organizers Survey	Form and Instruction
Organizer Survey Organizer Survey Attachment 1-Organizer Survey_052313.doc	Form and Instruction
Attachment 5-Initial E-mail to Organizers-Organizer Survey_052313.doc Initial E-mail to Organizers	IC Document
Attachment 6-Reminder E-mail to Organizers-Organizer Survey_052313.doc Reminder E-mail to Organizers	IC Document
Attachment 4-ICF IRB Review Findings Form_12.19.13.pdf IRB Review Form	IC Document

IC Title:

Organizers Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	Organizer Survey	Organizer Survey	Attachment 1-Organizer Survey_052313.doc		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,220

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,220	-1,180	3,400
Annual IC Time Burden (Hours)	739	-961	1,700
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Initial E-mail to Organizers	Attachment 5-Initial E-mail to Organizers-Organizer Survey_052313.doc	08/20/2013
Reminder E-mail to Organizers	Attachment 6-Reminder E-mail to Organizers-Organizer Survey_052313.doc	08/20/2013
IRB Review Form	Attachment 4-ICF IRB Review Findings Form_12.19.13.pdf	01/02/2014

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