FY16Q3 Inventory Justification

0920-1036 Change Request Justification FY2016 Q3.docx

Community Assessment for Public Health Emergency Response (CASPER)

FY16Q3 Inventory Justification

OMB: 0920-1036

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NCEH GENERIC CLEARANCE FOR “COMMUNITY ASSESSMENT FOR PUBLIC HEALTH EMERGENCY RESPONSE (CASPER)”

OMB CONTROL NO. 0920-1036 (EXP. DATE 12/31/2017)


QUARTERLY CHANGE REQUEST

JUSTIFICATION: This is a change request to report the actual burden hours used for CASPER GenICs.

REPORTING PERIOD

FISCAL YEAR: 2016

QUARTER: 3


SUMMARY OF APPROVED NUMBER OF RESPONSES AND BURDEN HOURS


APPROVED DATES

DATE OF COLLECTION

RESPONSES

BURDEN HOURS

GENERIC CLEARANCE

Exp Date

12/31/2017


9600

4731

BALANCE REMAINING



9199

4534

GenIC REPORT

Undetermined health effects among persons affected by flooding – West Virginia, 2016

7/21/2016

10/19/2016

08/01/2016 08/02/2016

392

196

(11760/60 minutes)

9

0.75

(45/60 minutes)

GenIC Attachments:

WV Flood 2016 CASPER Questionnaire - final

WV Flood 2016 Referral Form - final



Attachment H. Burden Memo - final



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