Information Collection Request

Emergency Epidemic Investigation Data Collections

ICR 202209-0920-030 · OMB 0920-1011 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-1011 VIM-Carbapenem Resistant Pseudomonas aeruginosa (VIM-CRPA) Outbreak Investigation Abstraction Form Form New Available
Published 30dy221011.pdf Supplementary Document Uploaded 2022-09-29 Repair queued
EEI GenICR_Sup St A_10.03.22.docx Supporting Statement A Uploaded 2022-10-03 Repair queued
EEI GenICR_Sup St B.docx Supporting Statement B Uploaded 2022-09-29 Repair queued
App 6_Online Survey Case Finding Questionnaire.docx Supplementary Document Uploaded 2022-09-29 Repair queued
App 5_Phone Interview Questionnaire Patient.docx Supplementary Document Uploaded 2022-09-29 Repair queued
App 4_Q Fever Person Interview Questionnaire.docx Supplementary Document Uploaded 2022-09-29 Repair queued
App 3 _Hantav Pulm Synd Questionnaire.docx Supplementary Document Uploaded 2022-09-29 Repair queued
App 2_GBS Case Questionnaire.docx Supplementary Document Uploaded 2022-09-29 Repair queued
App 1_Chart Abstract Form.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attach H_Biospecimen Storage Consent.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attach G_Emer Epi Invest_IRB Letter.pdf Supplementary Document Uploaded 2022-09-29 Repair queued
Attach F_Epi Invest SORN.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attach E_Burden Memo.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attach D_GenIC Request Form for Emergency Epidemic Investigation.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attach C_ Steps Conduct Emer Epi Invest.docx Supplementary Document Uploaded 2022-09-29 Repair queued
Attach B_EEI Extension 60 Day FRN.pdf Supplementary Document Uploaded 2022-09-29 Repair queued
EEI GenICR_0920-13ZJ_Attach A_Auth Legis Emer Epi Invest_11-06-2013_Subm.pdf Supplementary Document Uploaded 2013-11-20 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
257566 VIM-Carbapenem Resistant Pseudomonas aeruginosa (VIM-CRPA) Outbreak Investigation Abstraction Form Form New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 01/31/2023
12,000 805,759
6,000 402,874
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 12,000 805,759 0 -793,759 0 0
Annual Time Burden (Hours) 6,000 402,874 0 -396,874 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No