Information Collection

[NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation

IC 273877 under ICR 202506-0920-010 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 25-0003 [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form
Form 25-0003 Screener [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form
Form 25-0003 Eligibility Screener [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form
Form 25-0003 Moderator Guide [NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation	Form
25-0003 Screener Attachment 1 - Eligibility Screener_FG.docx	Form
25-0003 Screener Attachment 1 - Eligibility Screener_FG.docx	Form
25-0003 Eligibility Screener Attachment 3 - Eligible Participant Screener_2.21.25.docx	Form
25-0003 Eligibility Screener Attachment 3 - Eligible Participant Screener_2.21.25.docx	Form
25-0003 Moderator Guide Attachment 8 - Moderator Guide_FG.docx	Form
25-0003 Moderator Guide Attachment 8 - Moderator Guide_FG.docx	Form
Supporting Statement A Algal Blooms.docx SSA	IC Document
Supporting Statement A Algal Blooms.docx SSA	IC Document
Supporting Statement B.docx SSB	IC Document
Supporting Statement B.docx SSB	IC Document
Attachment 2 - Recruitment Materials_FG.docx Recruitment Material	IC Document
Attachment 2 - Recruitment Materials_FG.docx Recruitment Material	IC Document
Attachment 4 - Privacy Agreement.docx Privacy Agreement	IC Document
Attachment 4 - Privacy Agreement.docx Privacy Agreement	IC Document
Attachment 5 - Respondent Consent Form_FG.docx Respondent Consent	IC Document
Attachment 5 - Respondent Consent Form_FG.docx Respondent Consent	IC Document
Attachment 6 - Standard Invitation_FG .docx Invitation	IC Document
Attachment 6 - Standard Invitation_FG .docx Invitation	IC Document
Attachment 7 - Participant Confirmation Email_FG.docx Confirmation Email	IC Document
Attachment 7 - Participant Confirmation Email_FG.docx Confirmation Email	IC Document
Attachment 9 - Materials for testing.docx Material for Testing	IC Document
Attachment 9 - Materials for testing.docx Material for Testing	IC Document
GenIC Request HAB Communication Evaluation.docx GenIC Request	IC Document
GenIC Request HAB Communication Evaluation.docx GenIC Request	IC Document
Attachment 10- Human Subjects Determination.pdf Human Subjects Determination	IC Document
Attachment 10- Human Subjects Determination.pdf Human Subjects Determination	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[NCZEID] Harmful Algal Blooms Shellfish Communication Evaluation

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	25-0003	Yes	Yes	Fillable Fileable
Form	25-0003	Yes	Yes	Fillable Fileable
Form	25-0003	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 532

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	532	532
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA		02/21/2025
SSB		01/28/2025
Recruitment Material		01/28/2025
Privacy Agreement		01/28/2025
Respondent Consent		01/28/2025
Invitation		01/28/2025
Confirmation Email		01/28/2025
Material for Testing		01/28/2025
GenIC Request		01/28/2025
Human Subjects Determination		01/28/2025

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

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