2014012-XXX Resp Illness UC_CA

Emergency Epidemic Investigation Data Collections - Expedited Reviews

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Appendix 1. Interview Form.docx Other-WORD
2014012-XXX_Resp Illness UC_CA.docx Other-WORD
FW CDC Epi Aid request received from ORR.msg Other-Email

Information Collection (IC) Details

IC Title:	2014012-XXX Resp Illness UC_CA	Agency IC Tracking Number:	15AOH

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Appendix 1. Interview Form.docx	Yes	Yes	Fillable Printable
Other-WORD	2014012-XXX_Resp Illness UC_CA.docx	Yes	Yes	Fillable Printable
Other-Email	FW CDC Epi Aid request received from ORR.msg	No		Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	83	83
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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