Information Collection

Undetermined source for Salmonella Infantis infections among detention center inmates - South Carolina, 2016

IC 223019 under ICR 201608-0920-012 · OMB 0920-1011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:

Documents and Forms

Documents and forms in this information collection
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

IC Title:

Undetermined source for Salmonella Infantis infections among detention center inmates - South Carolina, 2016

Agency IC Tracking Number:

0920-1011-16BAX

IC Status: Unchanged

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	NA	Salmonella Infantis Infections among Detention Center Inmates - Case Interview Form	Appendix I_Inmate Interview Form_8 15 16.docx	NA	No		Paper Only

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 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.