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Undetermined source for Salmonella Infantis infections among detention center inmates - South Carolina, 2016
Emergency Epidemic Investigation Data Collections - Expedited Reviews
OMB: 0920-1011
IC ID: 223019
OMB.report
HHS/CDC
OMB 0920-1011
ICR 201604-0920-011
IC 223019
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:
2022-10-07 - Revision of a currently approved collection
2022-01-13 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Undetermined source for Salmonella Infantis infections among detention center inmates - South Carolina, 2016
Form and Instruction
Salmonella Infantis Infections among Detention Center In
Appendix I_Inmate Interview Form_8 15 16.docx
Form and Instruction
SC LOI_Signed_20160812.pdf
Letter of Invitation - South Carolina
IC Document
Burden Memo Email.msg
Burden Memo Email
IC Document
Appendix II_Infantis_MedChartForm_DRAFT_8 15 16.docx
Medical Chart Abstraction Form
IC Document
GenIC Request Form - EEI Generic ICR 16AUG2016.docx
GenIC Request
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Undetermined source for Salmonella Infantis infections among detention center inmates - South Carolina, 2016
Agency IC Tracking Number:
0920-1011-16BAX
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
Salmonella Infantis Infections among Detention Center Inmates - Case Interview Form
Appendix I_Inmate Interview Form_8 15 16.docx
NA
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
Epidemic Investigation Case Records - 09-20-0113
FR Citation:
51 FR 42466
Number of Respondents:
300
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
300
0
300
0
0
0
Annual IC Time Burden (Hours)
225
0
225
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Letter of Invitation - South Carolina
SC LOI_Signed_20160812.pdf
08/15/2016
Burden Memo Email
Burden Memo Email.msg
08/15/2016
Medical Chart Abstraction Form
Appendix II_Infantis_MedChartForm_DRAFT_8 15 16.docx
08/15/2016
GenIC Request
GenIC Request Form - EEI Generic ICR 16AUG2016.docx
08/16/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.