Att3b ACE Invstgtn GenIC Advnc Ntfictn

Att3b ACE Invstgtn GenIC Advnc Ntfictn.docx

[ATSDR] Assessment of Chemical Exposures (ACE) Investigations

Att3b ACE Invstgtn GenIC Advnc Ntfictn

OMB: 0923-0051

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Attachment 3b. Notification Email Template - “GenIC Expedited Approval Request Notification”

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The purpose of the “GenIC Expedited Approval Request Notification” email is to give ICRO, HHS, and OMB advance notification that an expedited request for OMB approval (in 72 or 24-hours) for an ACE Investigation will be received with justification. The team is in the planning stages and wants to alert OMB that an expedited request is forthcoming. Requests for 5-day approvals will be submitted to ICRO without advance notification through customary agency procedures.





From: [ACE Investigation Information Collection Request Liaison (ICRL)]
To: [CDC OMB Clearance Mailbox]; [Chief, CDC Information Collection Review Office]
Subject: Expedited Approval Request Notification for GenIC 0923-0051 – ACE Investigations


This is advance notification that NCEH/ATSDR will submit the following GenIC request for expedited approval to the CDC Information Collection Review Office (ICRO) within the next [insert] day(s). We request that ICRO provide HHS and the OMB Desk Officer this preliminary information as soon as possible.


INVESTIGATION LEAD:

Name:

Title:

Affiliation:

CDC/ATSDR SPONSORING PROGRAM: [insert]


NAME, TITLE, AND CONTACT INFORMATION OF PROGRAM CONTACT: [insert]


TITLE OF INFORMATION COLLECTION: [insert]


REQUESTED TYPE OF EXPEDITED APPROVAL AND EFFECTIVE DATE:

[ ] 72-hour [ ] 24-hour Requested Approval Date: [insert]


JUSTIFICATION: [insert reason why 72 or 24-hour approval is requested and a description of the public health need]


DESCRIPTION OF THIS SPECIFIC COLLECTION:

  1. Environmental incident to be Investigated:

[insert]


  1. Location of the Investigation:

[insert]

  1. Agency Requesting Epidemiological Assistance/Name and Title of Requestor: [insert]


  1. Target Population:

[ ] Exposed Individuals

[ ] Households

[ ] Health Care Facility Staff

[ ] Veterinary Facility Staff

[ ] Other [insert]



5. Duration of Data Collection will be 90 days or less.



Please advise if additional action is required.

[Signature Block]


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