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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.