Information Collection

Domestic Readiness Initiative on Zika Virus Disease - Year 2 Core Campaign Materials

IC 226496 under ICR 201502-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Domestic Readiness Initiative on Zika Virus Disease - Year 2 Core Campaign Materials	Form and Instruction
Focus Group Screener Attachment_1_Screener for Focus Groups.docx	Form and Instruction
Focus Group Guide Attachment 2_Focus Group Guide.docx	Form and Instruction
HMTS Expedited Review Form_Zika Readiness Initiative Campaign_Year 2 Core Campaign Materials Testing.pdf HMTS Expedited Review Form	IC Document
Attachment 3_Concepts for Testing_US PR_2 Concepts.pptx Concepts (2) for Testing US/PR	IC Document

IC Title:

Domestic Readiness Initiative on Zika Virus Disease - Year 2 Core Campaign Materials

Agency IC Tracking Number:

0920-0572-17AGK

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 and Instruction	NA	Focus Group Screener	Attachment_1_Screener for Focus Groups.docx	NA	No		Paper Only
Form and Instruction	NA	Focus Group Guide	Attachment 2_Focus Group Guide.docx	NA	No		Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	81	81
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
HMTS Expedited Review Form	HMTS Expedited Review Form_Zika Readiness Initiative Campaign_Year 2 Core Campaign Materials Testing.pdf	04/21/2017
Concepts (2) for Testing US/PR	Attachment 3_Concepts for Testing_US PR_2 Concepts.pptx	04/26/2017

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