Information Collection

Survey of County-Level Surveillance Records of Aedes aegypti and Aedes albopictus

IC 220152 under ICR 201603-0920-014 · OMB 0920-1101.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Survey of County-Level Surveillance Records of Aedes aegypti and Aedes albopictus	Form and Instruction
CDC Survey of County-Level Surveillance Records of Aedes Att. J -- Survey of county-level surveillance records of mosquitoes.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	CDC Survey of County-Level Surveillance Records of Aedes aegypti and Aedes albopictus from 2000 - Present	Att. J -- Survey of county-level surveillance records of mosquitoes.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0136 - Epidemiological Studies and Surveillance of Disease Problems

FR Citation: 57 FR 62812

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.