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KAP Survey (Pre/Post)
Community-based Tick Control for the Prevention of Rocky Mountain Spotted Fever in Hermosillo, Mexico
OMB: 0920-1110
IC ID: 219606
OMB.report
HHS/CDC
OMB 0920-1110
ICR 201601-0920-006
IC 219606
( )
Documents and Forms
Document Name
Document Type
KAP Survey (Pre/Post)
Form and Instruction
KAP Questionnaire
Att D--KAP Questionnaire_1-12-2016.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
KAP Survey (Pre/Post)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
NA
KAP Questionnaire
Att D--KAP Questionnaire_1-12-2016.docx
NA
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
800
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,600
0
1,600
0
0
0
Annual IC Time Burden (Hours)
533
0
533
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.