OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Covid-19 Impact Survey

IC 244367 under ICR 202102-0920-008 · OMB 0920-1171.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Covid-19 Impact Survey 0920-21CS
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-21CS COVID-19 Impact Study, 2020 ITEM #6 Appendix C.3_COV-IMP Survey_11-12_clean.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0136, Epidemiologic Studies and Surveillance of Disease Problems  81 FR 9200

1,330 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,330 0 0 0 0 1,330
Annual IC Time Burden (Hours) 554 0 0 0 0 554
Annual IC Cost Burden (Dollars) 14,252 0 0 0 0 14,252

Title Document Date Uploaded
Change Request Memo OMB0920_1171 NonSubstantive Change Request Memo_11-13-2020.docx 12/08/2020
Expedited Review Request OMB 0920-1171 Expedited Review request_.docx 12/08/2020
Change Request OMB0920_1171 NonSubstantive Change_Spanish_1-20-21_final.docx 02/18/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.