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Federal forms, ICRs, and supporting documents

Information Collection

Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives

IC 232627 under ICR 201803-0920-013 · OMB 0920-0932.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form 0920-0932
Viajo sin Zika Online Focus Group Screener - English Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives		 Form and Instruction
Form 0920-0932
Viajo sin Zika Online Focus Group Screener - Spanish Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives		 Form and Instruction
Form 0920-0932
Viajo sin Zika Online Focus Group Moderator Guide - English Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives		 Form and Instruction
Form 0920-0932
Viajo sin Zika Online Focus Group Moderator Guide - Spanish Information Collection to Assess the Viajo sin Zika Awareness Communication Campaign for Hispanics/Latinos Visiting Friends and Relatives		 Form and Instruction
0920-0932 Viajo sin Zika Online Focus Group Screener - English
Att D - Online screener.docx 		Form and Instruction
0920-0932 Viajo sin Zika Online Focus Group Screener - Spanish
Att D - Online screener (Spanish).docx 		Form and Instruction
0920-0932 Viajo sin Zika Online Focus Group Moderator Guide - Engl
Att E - Focus Group Moderators Guide.docx 		Form and Instruction
0920-0932 Viajo sin Zika Online Focus Group Moderator Guide - Span
Att E - Focus Group Moderators Guide (Spanish).docx 		Form and Instruction
Att A - Email invitation to partner organizations.docx
Email Invitation to Partner Organizations		IC Document
Att B - Email invitation to partner organization members.docx
Email Invitation to Partner Organization Members		IC Document
Att C - Recruitment Flyer.docx
Recruitment Flyer - English		IC Document
Att C - Recruitment Flyer (Spanish).docx
Recruitment Flyer - Spanish		IC Document
Att F - IRB Determination.pdf
IRB Determination		IC Document
Viajo sin Zika_Supporting Statement A_8.9.18_FINAL.docx
Supporting Statement A		IC Document
Viajo sin Zika_Supporting Statement B_8.9.18.docx
Supporting Statement B		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 0920-0932 NA Yes Yes Fillable Fileable
Form and Instruction 0920-0932 NA Yes Yes Fillable Fileable
Form and Instruction 0920-0932 NA Yes Yes Fillable Fileable
Form and Instruction 0920-0932 NA Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 216 0 216 0 0 0
Annual IC Time Burden (Hours) 84 0 84 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Email Invitation to Partner Organizations 08/15/2018
Email Invitation to Partner Organization Members 08/15/2018
Recruitment Flyer - English 08/15/2018
Recruitment Flyer - Spanish 08/15/2018
IRB Determination 08/15/2018
Supporting Statement A 08/15/2018
Supporting Statement B 08/15/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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