Participatory Mapping to Identy and Support at Risk Population in Emergency Preparedness -- Phase 2

CDC/ATSDR Formative Research and Tool Development

⚠️ Notice: This information collection may be referencing outdated material.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

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

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

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 Agency Discretion
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	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.