Information Collection

[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention

IC 273434 under ICR 202507-0920-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 0920-1154 [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Eligibility Screener - Focus Group [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Eligible Participant Screener - Focus Group [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Eligibility Screener - Survey [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Focus Group Moderator Guide [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
Form 0920-1154 Rapid Online Survey [NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention	Form and Instruction
0920-1154 Eligibility Screener - Focus Group Attachment 1 - Eligibility Screener_FG.docx	Form and Instruction
0920-1154 Eligibility Screener - Focus Group Attachment 1 - Eligibility Screener_FG.docx	Form and Instruction
0920-1154 Eligible Participant Screener - Focus Group Attachment 3 - Eligible Participant Screener_FG.docx	Form and Instruction
0920-1154 Eligible Participant Screener - Focus Group Attachment 3 - Eligible Participant Screener_FG.docx	Form and Instruction
0920-1154 Eligibility Screener - Survey Attachment 9 - Eligibility Screener for Rapid Survey.docx	Form and Instruction
0920-1154 Eligibility Screener - Survey Attachment 9 - Eligibility Screener for Rapid Survey.docx	Form and Instruction
0920-1154 Focus Group Moderator Guide Attachment 8 - Focus Group Moderator Guide.docx	Form and Instruction
0920-1154 Focus Group Moderator Guide Attachment 8 - Focus Group Moderator Guide.docx	Form and Instruction
0920-1154 Rapid Online Survey Attachment 11 - Rapid Survey.docx	Form and Instruction
0920-1154 Rapid Online Survey Attachment 11 - Rapid Survey.docx	Form and Instruction
Attachment 2 - Recruitment Materials_FG.docx Recruitment Materials - FG	IC Document
Attachment 2 - Recruitment Materials_FG.docx Recruitment Materials - FG	IC Document
Attachment 5 - Respondent Consent Form_FG.docx Consent Form - FG	IC Document
Attachment 5 - Respondent Consent Form_FG.docx Consent Form - FG	IC Document
Attachment 6 - Standard Invitation_FG.docx Standard Invitation - FG	IC Document
Attachment 6 - Standard Invitation_FG.docx Standard Invitation - FG	IC Document
Attachment 7 - Participant Confirmation Email_FG.docx Participant Confirmation Email - FG	IC Document
Attachment 7 - Participant Confirmation Email_FG.docx Participant Confirmation Email - FG	IC Document
Attachment 13 - Recruitment Materials_Survey.docx Recruitment Materials - Survey	IC Document
Attachment 13 - Recruitment Materials_Survey.docx Recruitment Materials - Survey	IC Document
Attachment 12 - Respondent Consent Form_Survey.docx Consent Form - Survey	IC Document
Attachment 12 - Respondent Consent Form_Survey.docx Consent Form - Survey	IC Document
Attachment 15 - Messages to be tested.docx Test Messages	IC Document
Attachment 15 - Messages to be tested.docx Test Messages	IC Document
Attachment 16- Human Subjects Determination.pdf Non-Research Determination	IC Document
Attachment 16- Human Subjects Determination.pdf Non-Research Determination	IC Document
Attachment 4 - Privacy Agreement.docx Privacy Agreement	IC Document
Attachment 4 - Privacy Agreement.docx Privacy Agreement	IC Document
GenIC Request_DFWED.docx GenIC Request	IC Document
GenIC Request_DFWED.docx GenIC Request	IC Document
Supporting Statement A.docx Supporting Statement A	IC Document
Supporting Statement A.docx Supporting Statement A	IC Document
Supporting Statement B.docx Supporting Statement B	IC Document
Supporting Statement B.docx Supporting Statement B	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[NCEZID] Communication Evaluation Assessing Foodborne, Waterborne and Mycotic Disease Prevention

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.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable
Form and Instruction	0920-1154	N/A	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,794

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	6,794	6,794
Annual IC Time Burden (Hours)	650	650
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Recruitment Materials - FG		12/30/2024
Consent Form - FG		12/30/2024
Standard Invitation - FG		12/30/2024
Participant Confirmation Email - FG		12/30/2024
Recruitment Materials - Survey		12/30/2024
Consent Form - Survey		12/30/2024
Test Messages		12/30/2024
Non-Research Determination		12/30/2024
Privacy Agreement		12/30/2024
GenIC Request		12/30/2024
Supporting Statement A		12/30/2024
Supporting Statement B		12/30/2024

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].