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Federal forms, ICRs, and supporting documents

Information Collection

Flood-Related Community Assessment for Public Health Emergency Response (CASPER) – WV, 2016

IC 222058 under ICR 201406-0920-005 · OMB 0920-1036.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Flood-Related Community Assessment for Public Health Emergency Response (CASPER) – WV, 2016 0920-1036
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA WV Flood 2016 CASPER Questionnaire Flood CASPER Questions_clean.docx NA No   Paper Only
Form and Instruction NA WV Flood 2016 CASPER Referral Form Referral Form_WV_Flood_clean.docx NA No   Paper Only

Health Illness Prevention

 

215 0
   
Individuals or Households
 
   0 %

  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 215 0 215 0 0 0
Annual IC Time Burden (Hours) 105 0 105 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter of Invitation - West Virginia LOI_WVflood_CASPER_2016.pdf 07/21/2016
Burden Request Memo AttachH_Burden Memo.docx 07/21/2016
Research Determination Signed OS RDF Undetermined Health Effects Among Persons Affected by Flooding_WV 2016.pdf 07/21/2016
CASPER GenIC - Request for Approval G RqstAprvl 12052014 Clean_WV_final.docx 07/21/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.