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Restaurant intervention log - intervention restaurants
Assessment of Ill Worker Policies Study
OMB: 0920-1227
IC ID: 245315
OMB.report
HHS/CDC
OMB 0920-1227
ICR 202204-0920-004
IC 245315
( )
Documents and Forms
Document Name
Document Type
Restaurant intervention log - intervention restaurants
Form
Restaurant intervention log
P_Att 5 Intervention Log 201211.docx
Form
Restaurant intervention log
P_Att 5 Intervention Log 201211.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Restaurant intervention log - intervention restaurants
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
none
Restaurant intervention log
P_Att 5 Intervention Log 201211.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
53
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
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
53
0
0
0
0
53
Annual IC Time Burden (Hours)
27
0
0
0
0
27
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
