Information Collection

Cyclosporiasis National Hypothesis Generating Questionnaire

IC 226341 under ICR 201803-0920-019 · OMB 0920-1198.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1198 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Cyclosporiasis National Hypothesis Generating Questionnaire	Form and Instruction
Attachment 2. Crosswalk of Non-substantive changes to 2018 CNHGQ.DOCX	Other-Reference document. Summary of
Cyclosporiasis National Hypothesis Generating Questionna Attachment 1. CNHGQ 2018 Revisions.docm	Form and Instruction

IC Title:

Cyclosporiasis National Hypothesis Generating Questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	n/a	Cyclosporiasis National Hypothesis Generating Questionnaire - FAX version - rev. Spring 2018	Attachment 1. CNHGQ 2018 Revisions.docm		Yes	Yes	Printable Only
Other-Reference document. Summary of changes to be implemented in May 2018.			Attachment 2. Crosswalk of Non-substantive changes to 2018 CNHGQ.DOCX		No		Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,000	0	1,000
Annual IC Time Burden (Hours)	767	17	750
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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