Information Collection

MosquitoNet Surveillance System Focus Group

IC 229959 under ICR 201605-0920-001 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1050 MosquitoNet Surveillance System Focus Group	Form and Instruction
0920-1050 MosquitoNET Focus Group Discussion Guide Att. 1 - MosquitoNET Focus Group Discussion Guide.docx	Form and Instruction
Att. 2 - Recruitment letter.docx Recruitment Letter	IC Document
Att. 3 - Non-research determination.pdf Non-Research Determination	IC Document
GenIC Clearance Template - MosquitoNet Focus Group 06FEB2018.docx GenIC Request	IC Document

IC Title:

MosquitoNet Surveillance System Focus Group

Agency IC Tracking Number:

0920-1050-18NV

IC Status: New

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	0920-1050	MosquitoNET Focus Group Discussion Guide	Att. 1 - MosquitoNET Focus Group Discussion Guide.docx	NA	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Recruitment Letter	Att. 2 - Recruitment letter.docx	02/06/2018
Non-Research Determination	Att. 3 - Non-research determination.pdf	02/06/2018
GenIC Request	GenIC Clearance Template - MosquitoNet Focus Group 06FEB2018.docx	02/06/2018

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