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HAIC MuGSI CA CP-CRE Health interview
[NCEZID] Emerging Infections Program
OMB: 0920-0978
IC ID: 253048
OMB.report
HHS/CDC
OMB 0920-0978
ICR 202312-0920-011
IC 253048
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0978 can be found here:
2024-07-26 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 0920-0978
HAIC MuGSI CA CP-CRE Health interview
Form and Instruction
Form 0920-0978
HAIC MuGSI CA CP-CRE Health interview
Form and Instruction
0920-0978 Community-Associated CP-CRE Interview
Att9_HAIC_CA_CP_CRE_interviews_ questionnaire v 20_05252021.pdf
Form and Instruction
0920-0978 Community-Associated CP-CRE Interview
Att9_HAIC_CA_CP_CRE_interviews_ questionnaire v 20_05252021.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
HAIC MuGSI CA CP-CRE Health interview
Agency IC Tracking Number:
0920-0978-24BX
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
0920-0978
Community-Associated CP-CRE Interview
Att9_HAIC_CA_CP_CRE_interviews_ questionnaire v 20_05252021.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
10
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 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
100
0
0
0
0
100
Annual IC Time Burden (Hours)
50
0
0
0
0
50
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.