Information Collection

Investigation of SARS-CoV-2 transmission in a jail - Louisiana, 2020

IC 241734 under ICR 202009-0920-002 · OMB 0920-1011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1011 Investigation of SARS-CoV-2 transmission in a jail - Louisiana, 2020	Form and Instruction
0920-1011 Facility Assessment Appendix 1. Facility Survey.docx	Form and Instruction
0920-1011 Survey - Day 0 Appendix 2. Survey Day 0.docx	Form and Instruction
0920-1011 Survey - Day 3-4 Appendix 3. Survey Day 3.docx	Form and Instruction
0920-1011 Survey - Day 14 Appendix 4. Survey Day 14.docx	Form and Instruction
0920-1011 Respiratory Testing Form Appendix 5. Lab requisition form cover page.docx	Form and Instruction
0920-1011 COVID-19 Test Request Form Appendix 5. COVID-19 Test Request Form.pdf	Form and Instruction
2020004-XXX COVID-19 Jail_LA.docx 0920-1011 GenIC Request	IC Document
Letter of Invitation.pdf Letter of Invitation	IC Document
URGENT 0920-1011 GenIC Request 2020004-XXX COVID-19 Jail_LA.msg Burden Request Memo	IC Document

IC Title:

Investigation of SARS-CoV-2 transmission in a jail - Louisiana, 2020

Agency IC Tracking Number:

0920-1011-20OF

IC Status: Removed

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?	Electronic Capability
Form and Instruction	0920-1011	Facility Assessment	Appendix 1. Facility Survey.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Survey - Day 0	Appendix 2. Survey Day 0.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Survey - Day 3-4	Appendix 3. Survey Day 3.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Survey - Day 14	Appendix 4. Survey Day 14.docx	NA	No	Paper Only
Form and Instruction	0920-1011	Respiratory Testing Form	Appendix 5. Lab requisition form cover page.docx	NA	No	Paper Only
Form and Instruction	0920-1011	COVID-19 Test Request Form	Appendix 5. COVID-19 Test Request Form.pdf	NA	No	Paper Only

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records

Title: Epidemic Investigation Case Records - SORN number 09-20-0113

FR Citation: 51 FR 42466

Number of Respondents: 910

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-910	910
Annual IC Time Burden (Hours)	-356	356
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0920-1011 GenIC Request	2020004-XXX COVID-19 Jail_LA.docx	05/07/2020
Letter of Invitation	Letter of Invitation.pdf	05/07/2020
Burden Request Memo	URGENT 0920-1011 GenIC Request 2020004-XXX COVID-19 Jail_LA.msg	05/08/2020

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