Effective Communication for Water-related Emergencies and Disease Outbreaks

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Document Name Document Type
Effective Communication for Water-related Emergencies and Disease Outbreaks Form and Instruction
AttD_FocusGroup_Guide.docx Other-Focus group guide
Recruitment Screener AttA_Rcrtmnt_Protocol_Screening_Instrmnt.docx Form and Instruction
10.28.20_0923-0047_TmpltApprvlFrm b.pdf genIC Approval Request IC Document
AttB_Rcrtmnt_Flyer.docx Recruitment flyer IC Document
AttE_TstMsg1_Making_Water_Safe_Webpage.pdf Message 1 - Making water safe in emergencies IC Document
AttF_TstMsg2_Cleaning_Sntzng_Bleach_Webpage.pdf Message 2 - Cleaning and sanitizing with bleach IC Document
AttG_TstMsg3_Boil_Water_Facts.pdf Message 3 - Boil water facts IC Document
AttJ_STARS_Determination.pdf Project determination IC Document
10.28.20_Prjct Smmry_FocusGroups (1).docx Project summary IC Document
AttC_Participant_Info (1).docx Participant information sheet IC Document

Information Collection (IC) Details

IC Title:	Effective Communication for Water-related Emergencies and Disease Outbreaks	Agency IC Tracking Number:	0920-0047-21BE

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	none	Recruitment Screener	AttA_Rcrtmnt_Protocol_Screening_Instrmnt.docx		Yes	Yes	Fillable Fileable
Other-Focus group guide			AttD_FocusGroup_Guide.docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 315	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	315	315
Annual IC Time Burden (Hours)	173	173
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
genIC Approval Request	10.28.20_0923-0047_TmpltApprvlFrm b.pdf	11/18/2020
Recruitment flyer	AttB_Rcrtmnt_Flyer.docx	11/18/2020
Message 1 - Making water safe in emergencies	AttE_TstMsg1_Making_Water_Safe_Webpage.pdf	11/18/2020
Message 2 - Cleaning and sanitizing with bleach	AttF_TstMsg2_Cleaning_Sntzng_Bleach_Webpage.pdf	11/18/2020
Message 3 - Boil water facts	AttG_TstMsg3_Boil_Water_Facts.pdf	11/18/2020
Project determination	AttJ_STARS_Determination.pdf	11/18/2020
Project summary	10.28.20_Prjct Smmry_FocusGroups (1).docx	11/18/2020
Participant information sheet	AttC_Participant_Info (1).docx	11/18/2020

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