Information Collection

Survey on CDC NCEH Disaster-Related Death Certification Trainings

IC 249662 under ICR 201810-0923-002 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0923-21IP Attachment 2_Death Certification Online Survey Survey on CDC NCEH Disaster-Related Death Certification Trainings	Form and Instruction
Form 0923-21IP Attachment 2a_Death Certification Word Survey Survey on CDC NCEH Disaster-Related Death Certification Trainings	Form and Instruction
0923-21IP Attachment 2_Death Certification Online Survey Attachment 2_Death Certification Online Survey.docx	Form and Instruction
0923-21IP Attachment 2a_Death Certification Word Survey Attachment 2a_Death Certification Word Survey.docx	Form and Instruction
ATSDR 0923-0047 TmpltApprvlFrm_Death Certification TtT Prgrm.docx Request for Approval	IC Document
Attachment 1_Death Certification Training Evaluation Emails.docx Attachment 1_Death Certification Training Evaluation Emails	IC Document

IC Title:

Survey on CDC NCEH Disaster-Related Death Certification Trainings

Agency IC Tracking Number:

0923-21IP

IC Status: New

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	0923-21IP				Yes	Yes	Fillable Fileable
Form and Instruction	0923-21IP				Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 800

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval		10/06/2021
Attachment 1_Death Certification Training Evaluation Emails		10/06/2021

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

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