OMB
.report
Search
Vector Control Intervention Questionnaire
Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)
OMB: 0920-1254
IC ID: 234596
OMB.report
HHS/CDC
OMB 0920-1254
ICR 202204-0920-005
IC 234596
( )
Documents and Forms
Document Name
Document Type
Form 0920-18ANU
Vector Control Intervention Questionnaire
Form and Instruction
0920-18ANU Vector Control Questionnaire
7. EN Paper Questionnaire - Vector Control_NAM.docx
Form and Instruction
0920-18ANU Vector Control Questionnaire
7. EN Paper Questionnaire - Vector Control_NAM.docx
Form and Instruction
0920-18ANU Spanish Vector Control Questionnaire
7. ES Paper Questionnaire - Vector Control.docx
Form and Instruction
0920-18ANU Spanish Vector Control Questionnaire
7. ES Paper Questionnaire - Vector Control.docx
Form and Instruction
0920-1254 Vector Control Questionnaire - Data Collection Instrumen
Attachment 3_COPA Data Collection Instruments_combined 07APR2022.pdf
Form and Instruction
0920-1254 Vector Control Questionnaire - Data Collection Instrumen
Attachment 3_COPA Data Collection Instruments_combined 07APR2022.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Vector Control Intervention Questionnaire
Agency IC Tracking Number:
0920-1254
Is this a Common Form?
No
IC Status:
Modified
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
0920-18ANU
Vector Control Questionnaire
7. EN Paper Questionnaire - Vector Control_NAM.docx
na
No
Fillable Fileable
Form and Instruction
0920-18ANU
Spanish Vector Control Questionnaire
7. ES Paper Questionnaire - Vector Control.docx
na
No
Fillable Fileable
Form and Instruction
0920-1254
Vector Control Questionnaire - Data Collection Instruments (combined English/Spanish)
Attachment 3_COPA Data Collection Instruments_combined 07APR2022.pdf
NA
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
57 FR 62812
Number of Respondents:
2,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
2,500
0
1,100
0
1,400
0
Annual IC Time Burden (Hours)
417
0
67
0
350
0
Annual IC Cost Burden (Dollars)
3,545
0
1,007
0
2,538
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.