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Mosquito Bite Prevention Kit Feedback
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 0920-1071
IC ID: 226830
OMB.report
HHS/CDC
OMB 0920-1071
ICR 201503-0920-011
IC 226830
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:
2024-05-08 - Revision of a currently approved collection
2024-03-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Mosquito Bite Prevention Kit Feedback
Form
Mosquito Prevention Kit Feedback - English
Att. 1 - MPK Feedback Postcard - ENGLISH.pdf
Form
Mosquito Prevention Kit Feedback - Spanish
Att. 1 - MPK Feedback Postcard - SPANISH.pdf
Form
Service Delivery Fast Track Template_MPK 2017.docx
Request for Approval
IC Document
Att. 2 - IRB Determination.pdf
IRB Determination
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Mosquito Bite Prevention Kit Feedback
Agency IC Tracking Number:
17AHY
IC Status:
New
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
Mosquito Prevention Kit Feedback - English
Att. 1 - MPK Feedback Postcard - ENGLISH.pdf
No
Paper Only
Form
none
Mosquito Prevention Kit Feedback - Spanish
Att. 1 - MPK Feedback Postcard - SPANISH.pdf
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
14,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
14,000
0
14,000
0
0
0
Annual IC Time Burden (Hours)
1,633
0
1,633
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Request for Approval
Service Delivery Fast Track Template_MPK 2017.docx
05/15/2017
IRB Determination
Att. 2 - IRB Determination.pdf
05/15/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.