Foodborne Illness Outbreak Investigation Survey for FSIS Public Health Partners

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0175 can be found here:

Documents and Forms

Document Name Document Type
FSIS food outbreak partner survey_FY19_FSIS cleared_for OMB.docx Other-web survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Foodborne Illness Outbreak Investigation Survey for FSIS Public Health Partners	Agency IC Tracking Number:

Is this a Common Form? No		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-web survey			FSIS food outbreak partner survey_FY19_FSIS cleared_for OMB.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 106	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	106	106
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.