Undetermined source of Elizabethkingia anophelis infections among Wisconsin residents - Wisconsin, 2016

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⚠️ Notice: This information collection may be referencing outdated material.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
Undetermined source of Elizabethkingia anophelis infections among Wisconsin residents - Wisconsin, 2016 Form and Instruction
Focus Group Discussion Guide Appendix 1. Focus Group.doc Form and Instruction
LOI_EKM_WI Focus Groups_mw JD rev 7 11 JPD final signed.pdf Letter of Invitation - Wisconsin IC Document
2016019-XXX Elizabethkingia_WI.docx GenIC Request GenIC - Elizabethkingia anophelis - Wisconsin IC Document
Burden Memo Email 0920-1011.msg Burden Request Memo - Email IC Document

Information Collection (IC) Details

IC Title:	Undetermined source of Elizabethkingia anophelis infections among Wisconsin residents - Wisconsin, 2016	Agency IC Tracking Number:	0920-1011-16AVO

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 and Instruction	NA	Focus Group Discussion Guide	Appendix 1. Focus Group.doc	NA	No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: 09-20-0113 - Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 51 FR 42466

Number of Respondents: 25	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	25	25
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Letter of Invitation - Wisconsin	LOI_EKM_WI Focus Groups_mw JD rev 7 11 JPD final signed.pdf	07/14/2016
GenIC Request GenIC - Elizabethkingia anophelis - Wisconsin	2016019-XXX Elizabethkingia_WI.docx	07/14/2016
Burden Request Memo - Email	Burden Memo Email 0920-1011.msg	07/14/2016

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