Att E ACE Investigation GenIC Advance Notification Email

Att E ACE Investigation GenIC Advance Notification Email _Clean March 2 2015.docx

Assessment of Chemical Exposures (ACE) Investigations - FY2016 Q2 Burden Report

Att E ACE Investigation GenIC Advance Notification Email

OMB: 0923-0051

Document [docx]
Download: docx | pdf

Attachment E. Notification Email Template - “GenIC Expedited Approval Request Notification”

Shape1

The purpose of the “GenIC Expedited Approval Request Notification” email is to give ICRO, HHS, and OMB advance notification that an expedited request for OMB approval (in 72 or 24-hours) for an ACE Investigation will be received with justification. The team is in the planning stages and wants to alert OMB that an expedited request is forthcoming. Requests for 5-day approvals will be submitted to ICRO without advance notification through customary agency procedures.


From: [ACE Investigation Information Collection Request Liaison (ICRL)]
To: [CDC OMB Clearance Mailbox]; [Chief, CDC Information Collection Review Office]
Subject: Expedited Approval Request Notification for GenIC 0923-XXXX – ACE Investigations


This is advance notification that NCEH/ATSDR will submit the following GenIC request for expedited approval to the CDC Information Collection Review Office (ICRO) within the next [insert] day(s). We request that ICRO provide HHS and the OMB Desk Officer this preliminary information as soon as possible.


INVESTIGATION LEAD:

Name:

Title:

Affiliation:

CDC/ATSDR SPONSORING PROGRAM: [insert]


NAME, TITLE, AND CONTACT INFORMATION OF PROGRAM CONTACT: [insert]


TITLE OF INFORMATION COLLECTION: [insert]


REQUESTED TYPE OF EXPEDITED APPROVAL AND EFFECTIVE DATE:

[ ] 72-hour [ ] 24-hour Requested Approval Date: [insert]


JUSTIFICATION: [insert reason why 72 or 24-hour approval is requested and a description of the public health need]


DESCRIPTION OF THIS SPECIFIC COLLECTION:

  1. Chemical incident to be Investigated:

[insert]


  1. Location of the Investigation:

[insert]

  1. Agency Requesting Epidemiological Assistance/Name and Title of Requestor::

[insert]


  1. Target Population:

[ ] Exposed Individuals

[ ] Households

[ ] Health Care Facility Staff

[ ] Veterinary Facility Staff

[ ] Other [insert]



5. Duration of Data Collection will be 90 days or less.



Please advise if additional action is required.

[Signature Block]

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorCDC User
File Modified0000-00-00
File Created2021-01-23

© 2024 OMB.report | Privacy Policy