Information Collection

HHS Region VI Virtual Tabletop Exercise Assessment

IC 223272 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
HHS Region VI Virtual Tabletop Exercise Assessment	Form
Exercise Findings Form Attachment A - Exercise Findings Form.docx	Form
Exercise Feedback Form Attachment B - Exercise Participant Feedback Form.docx	Form
O2C2 Supporting_Statement_A_VTTX.docx Supporting Statement A	IC Document
O2C2 Supporting_Statement_B_VTTX.docx Supporting Statement B	IC Document
Attachment C - Notification Email.docx Notification Email	IC Document
Attachment D - Reminder Email.docx Reminder Email	IC Document

IC Title:

HHS Region VI Virtual Tabletop Exercise Assessment

Agency IC Tracking Number:

16BCU

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	Exercise Findings Form	Attachment A - Exercise Findings Form.docx		Yes	Yes	Fillable Fileable
Form	none	Exercise Feedback Form	Attachment B - Exercise Participant Feedback Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 140

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	140	140
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A	O2C2 Supporting_Statement_A_VTTX.docx	08/31/2016
Supporting Statement B	O2C2 Supporting_Statement_B_VTTX.docx	08/31/2016
Notification Email	Attachment C - Notification Email.docx	08/31/2016
Reminder Email	Attachment D - Reminder Email.docx	08/31/2016

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