OMB
.report
Search
Message Testing: Radiation Emergencies and Cancer Risk
CDC and ATSDR Health Message Testing System
OMB: 0920-0572
IC ID: 242069
OMB.report
HHS/CDC
OMB 0920-0572
ICR 201806-0920-001
IC 242069
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:
2024-10-18 - Revision of a currently approved collection
2021-08-31 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-0572
Message Testing: Radiation Emergencies and Cancer Risk
Form and Instruction
AttB Online Survey 20200602.pdf
Other-Online Screenshot
0920-0572 Message Testing Survey
AttA Word Survey 20200602.docx
Form and Instruction
0 - HMTS Rqst GenIC RadiationEmrgncs CancerRisk 20200430.pdf
HMTS Request Template
IC Document
AttC Protocol 20200430.docx
Protocol
IC Document
AttD CDC 7275 Exempt Granted Memo 20200418.pdf
IRB approval
IC Document
0 - LIst of Attachments 20200430.docx
List of Attachments
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Message Testing: Radiation Emergencies and Cancer Risk
Agency IC Tracking Number:
0920-0572-20OV
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
Form and Instruction
0920-0572
Message Testing Survey
AttA Word Survey 20200602.docx
Yes
Yes
Fillable Fileable
Other-Online Screenshot
AttB Online Survey 20200602.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
600
0
600
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
HMTS Request Template
0 - HMTS Rqst GenIC RadiationEmrgncs CancerRisk 20200430.pdf
06/02/2020
Protocol
AttC Protocol 20200430.docx
06/02/2020
IRB approval
AttD CDC 7275 Exempt Granted Memo 20200418.pdf
06/02/2020
List of Attachments
0 - LIst of Attachments 20200430.docx
06/02/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.