20140006XXX Measles FSM

Emergency Epidemic Investigation Data Collections - Expedited Reviews

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1011 can be found here:

Documents and Forms

Document Name Document Type
2014006XXX_Measles_FSM.docx Other-WORD
Attachment 1. Measles Case Control Study Questionnaire.docx Other-WORD
INVITE_FSM.pdf Other-PDF
0920-1011 GenIC Request 2014006_Measles_FSM.msg Email Request IC Document

Information Collection (IC) Details

IC Title:	20140006XXX Measles FSM	Agency IC Tracking Number:	14AGH

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	2014006XXX_Measles_FSM.docx	Yes	Yes	Paper Only
Other-WORD	Attachment 1. Measles Case Control Study Questionnaire.docx	Yes	Yes	Fillable Printable
Other-PDF	INVITE_FSM.pdf	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Email Request	0920-1011 GenIC Request 2014006_Measles_FSM.msg	06/02/2014

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