Information Collection

Foodborne Illness Valuation Research

IC 259519 under ICR 202310-0536-005 · OMB 0536-0073.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0536-0073 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix 1. US Adult acute survey.docx	Other-Acute survey
Appendix 1. US Adult acute survey.docx	Other-Acute survey
Appendix 2. US Adult chronic survey.docx	Other-Chronic survey
Appendix 2. US Adult chronic survey.docx	Other-Chronic survey
Part A WTP.docx Part A WTP	IC Document
Part A WTP.docx Part A WTP	IC Document
Appendix 3. Recruitment Plan and Informed Consent.docx Appendix 3. Recruitment Plan and Informed Consent	IC Document
Appendix 3. Recruitment Plan and Informed Consent.docx Appendix 3. Recruitment Plan and Informed Consent	IC Document
Appendix 4. AmeriSpeak Technical Overview.pdf Appendix 4. AmeriSpeak Technical Overview	IC Document
Appendix 4. AmeriSpeak Technical Overview.pdf Appendix 4. AmeriSpeak Technical Overview	IC Document
Appendix 5. Pretest Plan and Scripts.docx Appendix 5. Pretest Plan and Scripts	IC Document
Appendix 5. Pretest Plan and Scripts.docx Appendix 5. Pretest Plan and Scripts	IC Document

IC Title:

Foodborne Illness Valuation Research

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 7 CFR 2204

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Acute survey					Yes	Yes	Fillable Fileable
Other-Chronic survey					Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Industry Sector Income Stabilization

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,020

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,020	1,020
Annual IC Time Burden (Hours)	305	305
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Part A WTP		05/02/2023
Appendix 3. Recruitment Plan and Informed Consent		05/02/2023
Appendix 4. AmeriSpeak Technical Overview		05/02/2023
Appendix 5. Pretest Plan and Scripts		05/02/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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