National Disease Surveillance Program

ICR 201912-0920-004

OMB: 0920-0009

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Unchanged
Form and Instruction
Unchanged
Form and Instruction
Unchanged
Supplementary Document
2019-12-09
Justification for No Material/Nonsubstantive Change
2019-12-09
Supplementary Document
2019-06-12
Supplementary Document
2019-06-12
Supplementary Document
2019-06-12
Supplementary Document
2019-06-12
Supplementary Document
2019-06-12
Supplementary Document
2019-06-12
Supplementary Document
2019-06-12
Justification for No Material/Nonsubstantive Change
2019-01-31
Supplementary Document
2019-01-31
Supporting Statement B
2019-06-12
Supporting Statement A
2019-06-12
IC Document Collections
ICR Details
0920-0009 201912-0920-004
Active 201905-0920-011
HHS/CDC 0920-0009
National Disease Surveillance Program
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 12/12/2019
Retrieve Notice of Action (NOA) 12/09/2019
Previous terms continue: OMB is approving this information collection request for a period of three years during which time the agency will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action. CDC will work with their OIRA desk officer in advance to determine whether changes should be submitted as revisions or as nonsubstative change request
  Inventory as of this Action Requested Previously Approved
08/31/2022 08/31/2022 08/31/2022
720 0 720
167 0 167
0 0 0

The purpose of this data collection is to collect disease specific surveillance reports of rare, uncommon, or infrequent diseases. The data will be used to determine the prevalence of diseases dangerous to public health. The data will also be used for planning and evaluating effective programs for prevention and control of infectious diseases. Disease incidence is needed to study present and emerging disease problems. Case data will be transmitted to CDC electronically or hard copy from State and Local Health Departments. This request is to make minor changes to the Acute Flaccid Myelitis Patient Summary Form with no change in burden.

US Code: 42 USC 241 Name of Law: Research and Investigations Generally
   US Code: 42 USC 301 Name of Law: General Powers and Duties of Public Health Service
  
None

Not associated with rulemaking

  84 FR 13927 04/08/2019
84 FR 30121 06/26/2019
No

4
IC Title Form No. Form Name
Att D-4_Acute Flaccid Myelitis none Acute Flaccid Myelitis Patient Summary Form
Att D-3_Reye Syndrome 0920-0009 Reye Syndrome form
Att D-1_CJD 0920-0009 CJD form
Att D2_Kawasaki Syndrome 0920-0009 Kawasaki Syndrome form

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 720 720 0 0 0 0
Annual Time Burden (Hours) 167 167 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$10,000
No
    Yes
    No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
12/09/2019


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