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Participatory Mapping to Identy and Support at Risk Population in Emergency Preparedness -- Phase 2
CDC/ATSDR Formative Research and Tool Development
OMB: 0920-1154
IC ID: 232408
OMB.report
HHS/CDC
OMB 0920-1154
ICR 201610-0920-009
IC 232408
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:
2023-01-31 - Extension without change of a currently approved collection
2019-12-23 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Att 1-InterviewComLead_OMB.docx
Other-WORD
Request for Approval-GenICTemplate_OMB_23July18_instrument2.docx
Request for Approval 0920-1154 (18ATQ)
IC Document
SSA_ParticipatoryMapping2_OMB_25July18.docx
SupSta A
IC Document
SSB_ParticipatoryMapping_OMB_instrument_23July18.docx
SupSta B
IC Document
Att 1-InterviewComLead_OMB.DRAFT.docx
Att 1_DRAFT Interview Guide
IC Document
Att 2_ IRB HSPH_Exemption_Letter-29_May_2018.pdf
Att 2_Harvard T.H. Chan School of Public Health IRB
IC Document
Att 3_6972 Exempt Amendment Memo_CDC_IRB.docx
Att 3_CDC IRB Approval
IC Document
Att 4_Invitation Letter_instrument_2.docx
Att 4_ Invitation Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participatory Mapping to Identy and Support at Risk Population in Emergency Preparedness -- Phase 2
Agency IC Tracking Number:
0920-1154 (18ATQ)
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-WORD
Att 1-InterviewComLead_OMB.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Disaster Preparedness and Planning
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
75
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
75
0
75
0
0
0
Annual IC Time Burden (Hours)
150
0
150
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Request for Approval 0920-1154 (18ATQ)
Request for Approval-GenICTemplate_OMB_23July18_instrument2.docx
07/30/2018
SupSta A
SSA_ParticipatoryMapping2_OMB_25July18.docx
07/30/2018
SupSta B
SSB_ParticipatoryMapping_OMB_instrument_23July18.docx
07/30/2018
Att 1_DRAFT Interview Guide
Att 1-InterviewComLead_OMB.DRAFT.docx
07/30/2018
Att 2_Harvard T.H. Chan School of Public Health IRB
Att 2_ IRB HSPH_Exemption_Letter-29_May_2018.pdf
07/30/2018
Att 3_CDC IRB Approval
Att 3_6972 Exempt Amendment Memo_CDC_IRB.docx
07/30/2018
Att 4_ Invitation Letter
Att 4_Invitation Letter_instrument_2.docx
07/30/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.