Information Collection

Ebola_West Africa_2014

IC 213274 under ICR 201501-0920-020 · OMB 0920-1011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Ebola_West Africa_2014	Form and Instruction
Observation Guide Appendix 2. Ebola_Burial Practices Observation Guide.docx	Form and Instruction
Field Guide Appendix 1 Ebola_Burial Practices Field Guide for In-depth Interviews.docx	Form and Instruction
Focus Group Guide Appendix 3 Ebola_Burial Practices Focus Group Guide.docx	Form and Instruction
LOI.pdf Letter of Invitation	IC Document
2014020-XXX_Ebola_WestAfrica3[1].docx Requst Letter	IC Document

IC Title:

Ebola_West Africa_2014

Agency IC Tracking Number:

14AZY

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	none	Observation Guide	Appendix 2. Ebola_Burial Practices Observation Guide.docx	No	Paper Only
Form and Instruction	none	Field Guide	Appendix 1 Ebola_Burial Practices Field Guide for In-depth Interviews.docx	No	Paper Only
Form and Instruction	none	Focus Group Guide	Appendix 3 Ebola_Burial Practices Focus Group Guide.docx	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 113

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	113	113
Annual IC Time Burden (Hours)	105	105
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Letter of Invitation	LOI.pdf	09/29/2014
Requst Letter	2014020-XXX_Ebola_WestAfrica3[1].docx	10/02/2014

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