Follow-up Survey

Ready CDC

Documents and Forms

Document Name Document Type
Follow-up Survey Form
Follow-up Survey Attachment O_Follow-Up Survey Screen Shot.docx Form
Attachment E Follow-Up Survey.docx Follow-up Survey - word IC Document
Attachment K_Follow-Up Survey Email.docx Follow-up Survey Email IC Document

Information Collection (IC) Details

IC Title:	Follow-up Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Follow-up Survey	Attachment O_Follow-Up Survey Screen Shot.docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 600	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	600	600
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Follow-up Survey - word	Attachment E Follow-Up Survey.docx	05/08/2014
Follow-up Survey Email	Attachment K_Follow-Up Survey Email.docx	05/08/2014

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