Information Collection Request

CDC and ATSDR Health Message Testing System

ICR 202108-0920-006 · OMB 0920-0572 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0572 Tick- and Mosquito-borne Disease Prevention Message Evaluation Form and Instruction New Available
Attachment 3 - Health Message Testing System Expedited Review Form .docx Supplementary Document Uploaded 2021-08-30 Missing upstream
60dy210572 0052.docx Supplementary Document Uploaded 2021-08-30 Repair queued
Attachment 4-DemographicQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 5-MarketResearchExpQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 6-IntroductoryQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 7-CoreQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 8-ActivityTaskQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 9-FollowUpQuestions.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 10 - Examples-Data Collection Instruments 060308.docx Supplementary Document Uploaded 2021-08-05 Repair queued
Att 1-AuthLegislation.pdf Supplementary Document Uploaded 2021-08-05 Repair queued
Attachment 11 - IRB Ruling 060308.docx Supplementary Document Uploaded 2021-08-05 Repair queued
SS-PartB-HMTS .docx Supporting Statement B Uploaded 2021-08-30 Repair queued
SS-Part A HMTS .docx Supporting Statement A Uploaded 2021-08-30 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
251679 Tick- and Mosquito-borne Disease Prevention Message Evaluation Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 08/31/2021
55,575 55,575
7,410 7,410
0 0






table that charts list of burden
  Total Request 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 55,575 55,575 0 0 0 0
Annual Time Burden (Hours) 7,410 7,410 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No