Information Collection Request
[NCEZID] EMERGENCY - B. multivorans Ice Machine Multistate Investigation
ICR 202404-0920-002 · OMB 0920-1430 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1430 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Burkholderia multivorans Outbreak Investigation Case Report Form |
Form | New | Available |
| Burkholderia multivorans Outbreak Investigation Case Report Form |
Form | New | Repair queued |
 Supporting Statement A_B multivorans.docx |
Supporting Statement A | Uploaded 2024-04-04 | Available |
| Supporting Statement A_B multivorans.docx |
Supporting Statement A | Uploaded 2024-04-04 | Repair queued |
 Attachment 4-PIA REDCap.pdf |
Supplementary Document | Uploaded 2024-04-04 | Available |
| Attachment 4-PIA REDCap.pdf |
Supplementary Document | Uploaded 2024-04-04 | Repair queued |
| Emergency Request Memo_B multivorans 2024 national call for cases dbj.pdf |
Supplementary Document | Uploaded 2024-04-02 | Available |
| Emergency Request Memo_B multivorans 2024 national call for cases dbj.pdf |
Supplementary Document | Uploaded 2024-04-02 | Repair queued |
| Attachment 5-Human Subjects Determination.pdf |
Supplementary Document | Uploaded 2024-04-02 | Available |
| Attachment 5-Human Subjects Determination.pdf |
Supplementary Document | Uploaded 2024-04-02 | Repair queued |
| Attachment 1-Section 301 of the Public Health Service Act (42 USC 241).pdf |
Supplementary Document | Uploaded 2024-04-02 | Available |
| Attachment 1-Section 301 of the Public Health Service Act (42 USC 241).pdf |
Supplementary Document | Uploaded 2024-04-02 | Repair queued |
| Supporting Statement B_B multivorans 2024 national call for cases.docx |
Supporting Statement B | Uploaded 2024-04-02 | Available |
| Supporting Statement B_B multivorans 2024 national call for cases.docx |
Supporting Statement B | Uploaded 2024-04-02 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 266503 |  Burkholderia multivorans Outbreak Investigation Case Report Form |
Form | New | |
| 266503 | Burkholderia multivorans Outbreak Investigation Case Report Form |
Form | New |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1430 |
| Type of Information Collection | New collection (Request for a new OMB Control Number) |
| Agency Tracking No | 0920-24EK |
| Date Submitted to OIRA | 2024-04-04 |
| Requested Expiration Date | 2024-04-05 |