Information Collection

Shigella Hypothesis Generating Questionnaire

IC 242975 under ICR 202007-0920-012 · OMB 0920-1307.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1307 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-20HD Shigella Hypothesis Generating Questionnaire	Form and Instruction
0920-20HD Shigella Hypothesis Generating Questionnaire Appendix C. SHGQ_10.30.2020 English.docx	Form and Instruction
Appendix E. SHGQ__10.30.2020 Spanish.docx Shigella Hypothesis Generating Questionnaire Spanish	IC Document

IC Title:

Shigella Hypothesis Generating Questionnaire

Agency IC Tracking Number:

0920-20HD

Is this a Common Form? No

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	0920-20HD	Shigella Hypothesis Generating Questionnaire	Appendix C. SHGQ_10.30.2020 English.docx		No		Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	1,500	1,500
Annual IC Time Burden (Hours)	1,125	1,125
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Shigella Hypothesis Generating Questionnaire Spanish	Appendix E. SHGQ__10.30.2020 Spanish.docx	11/02/2020

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