Shigella Hypothesis Generating Questionnaire

ICR 202007-0920-012

OMB: 0920-1307

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Supplementary Document
2020-08-04
Supplementary Document
2020-08-04
Supplementary Document
2020-08-04
Supporting Statement B
2020-11-02
Supporting Statement A
2020-08-04
IC Document Collections
ICR Details
0920-1307 202007-0920-012
Active
HHS/CDC 0920-20HD
Shigella Hypothesis Generating Questionnaire
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 11/02/2020
Retrieve Notice of Action (NOA) 08/04/2020
  Inventory as of this Action Requested Previously Approved
11/30/2023 36 Months From Approved
1,500 0 0
1,125 0 0
0 0 0

There is currently no national, standardized hypothesis generating interview data collection instrument for use during single or multistate shigellosis cluster or outbreak investigations. The Shigella Hypothesis Generating Questionnaire (SHGQ) will be administered by state and local public health officials among cases as part of outbreak and cluster response.

US Code: 42 USC 241 Name of Law: PHSA
  
None

Not associated with rulemaking

  85 FR 10692 02/25/2020
85 FR 46630 08/03/2020
Yes

1
IC Title Form No. Form Name
Shigella Hypothesis Generating Questionnaire 0920-20HD Shigella Hypothesis Generating Questionnaire

  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 1,500 0 0 1,500 0 0
Annual Time Burden (Hours) 1,125 0 0 1,125 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a New Collection.

$14,176
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Kevin Joyce 404 639-1944 [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.
08/04/2020


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