Information Collection

Participatory Mapping to Identify and Support at-Risk Populations in Emergency Preparedness

IC 226552 under ICR 201610-0920-009 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment _1_ Interview Guide_Community Leaders_Final_instrument_1.docx	Other-Interview Guide
Harvard_GenIC_package_instrument_1.docx Request for Approval	IC Document
Harvard_Supporting Statement A_instrument_1.docx Supporting Statement A	IC Document
Harvard_Supporting Statement B_instrument_1.docx Supporting Statement B	IC Document
Attachment_2_IRB Harvard exemption letter.pdf IRB Exemption	IC Document
Attachment_3_Harvard_6972 Exempt Granted Memo.docx IRB Determination	IC Document
Attachment_4_Invitation Letter_instrument_1.docx Invitation Letter	IC Document

IC Title:

Participatory Mapping to Identify and Support at-Risk Populations in Emergency Preparedness

Agency IC Tracking Number:

17AEC

IC Status: New

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
Other-Interview Guide			Attachment _1_ Interview Guide_Community Leaders_Final_instrument_1.docx		Yes	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	Harvard_GenIC_package_instrument_1.docx	04/26/2017
Supporting Statement A	Harvard_Supporting Statement A_instrument_1.docx	04/26/2017
Supporting Statement B	Harvard_Supporting Statement B_instrument_1.docx	04/26/2017
IRB Exemption	Attachment_2_IRB Harvard exemption letter.pdf	04/26/2017
IRB Determination	Attachment_3_Harvard_6972 Exempt Granted Memo.docx	04/26/2017
Invitation Letter	Attachment_4_Invitation Letter_instrument_1.docx	04/26/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.