MosquitoNet Surveillance System Focus Group

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.