Information Collection Request

US-based Migrant Farm Workers Understanding and Use of Measures to Prevent Zika Transmission

ICR 201608-0920-005 · OMB 0920-1126 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Focus Group Discussion Form and Instruction Modified Available
Key Informant Interview Form and Instruction Modified Available
Nonsub change Migrant Worker ICR - 0920-1126.docx Justification for No Material/Nonsubstantive Change Uploaded 2016-08-10 Available
Appendix J_Verbal consent form_FGD_Spanish_CLEAN_8-4-2016.docx Supplementary Document Uploaded 2016-08-09 Available
Appendix H_Verbal consent form _KII-_Spanish_CLEAN_8-4-2016.docx Supplementary Document Uploaded 2016-08-09 Available
SSB - Emergency Zika Migrant Ag Workers_19 July 2016.docx Supporting Statement B Uploaded 2016-08-10 Available
Revised SSA - Emergency Zika Migrant Ag Workers_21 July 2016_OMB_GMTF.docx Supporting Statement A Uploaded 2016-08-10 Available
Signed Emergency Review Request Memo.pdf Supplementary Document Uploaded 2016-07-20 Available
Attachment K - IRB Review.pdf Supplementary Document Uploaded 2016-07-20 Available
Attachment J Verbal consent form Focus Group Discussion – Spanish.docx Supplementary Document Uploaded 2016-07-20 Available
Attachment I Verbal consent form Focus Group Discussion – English.docx Supplementary Document Uploaded 2016-07-20 Available
Attachment H Verbal consent form Key Informant Interview – Spanish.docx Supplementary Document Uploaded 2016-07-20 Available
Attachment G Verbal consent form Key Informant Interview – English.docx Supplementary Document Uploaded 2016-07-20 Available
Attachment B Zika Migrant Ag Workers 60 day FRN_19 July 2016.docx Supplementary Document Uploaded 2016-07-20 Available
Attachment A Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2016-07-20 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
222554 Focus Group Discussion Form and Instruction Modified
222552 Key Informant Interview Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2017 01/31/2017 01/31/2017
140 0 140
140 0 140
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 140 140 0 0 0 0
Annual Time Burden (Hours) 140 140 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No