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Federal forms, ICRs, and supporting documents

Information Collection

Undetermined cause of Acute Flaccid Myelitis, multiple states, United States, 2018

IC 236444 under ICR 201907-0920-001 · OMB 0920-1011.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Undetermined cause of Acute Flaccid Myelitis, multiple states, United States, 2018 0920-1011-19BHA
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1011 Acute Flaccid Myelitis Case Questionnaire - English Appendix 1. Questionnaire - English.docx NA No   Fillable Printable
Form and Instruction 0920-1011 Acute Flaccid Myelitis Case Questionnaire - Spanish Appendix 2. Questionnaire - Spanish.docx NA No   Fillable Printable

Disaster Management Emergency Response

Epidemic Investigation Case Records - 09-20-0113  51 FR 42466

210 0
   
Individuals or Households
 
   0 %

  Requested 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 210 0 0 0 0 210
Annual IC Time Burden (Hours) 210 0 0 0 0 210
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter of Invitation - MN LOI-MN.AFM.pdf 06/12/2019
Letter of Invitation - Concurrence_Multiple States Concurrence emails compilation.pdf 06/12/2019
Burden Table - Email 0920-1011 Burden Table - Email.msg 06/12/2019
EEI GenIC Request 2019003-XXX AFM_multi_REVISED 13JUN2019.docx 06/13/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.