Mosquito and Tick Control Program Questionnaire

[NCEZID] Vector Surveillance and Control Assessment: Mosquito and Tick Capacities

Documents and Forms

Document Name Document Type
Mosquito and Tick Control Program Questionnaire Form and Instruction
Mosquito and Tick Control Program Questionnaire Attachment 1 -Mosquito and Tick Control Program Questionnaire Word Version.docx Form and Instruction
Mosquito and Tick Control Program Questionnaire Attachment 1 -Mosquito and Tick Control Program Questionnaire Word Version.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Mosquito and Tick Control Program Questionnaire	Agency IC Tracking Number:	0920-23CA

Is this a Common Form? No		IC Status: New

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	n/a	Mosquito and Tick Control Program Questionnaire	Attachment 1 -Mosquito and Tick Control Program Questionnaire Word Version.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,109	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,109	1,109
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	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.