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Community Emergency Preparedness Survey
Who’s at Risk: From Hazards to Communities—An Approach for Operationalizing CDC Guidelines to Determine Risks, and Define, Locate and Reach At-Risk Populations in Public Health Emergencies
OMB: 0920-1221
IC ID: 228844
OMB.report
HHS/CDC
OMB 0920-1221
ICR 201807-0920-011
IC 228844
( )
Documents and Forms
Document Name
Document Type
Form 0920-1221
Community Emergency Preparedness Survey
Form and Instruction
Community Emergency Preparedness Survey - OMB Approved.docx
Other-WORD
Community Emergency Preparedness Survey_Spanish_7.11.18.docx
Other-WORD_Spanish Version
0920-1221 Los Angeles County Community Emergency Preparedness Surv
Survey-Proposed Change 30MAR2018.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Community Emergency Preparedness Survey
Agency IC Tracking Number:
0920-1221 (18ATL)
Is this a Common Form?
No
IC Status:
Modified
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
0920-1221
Los Angeles County Community Emergency Preparedness Survey
Survey-Proposed Change 30MAR2018.docx
NA
No
Paper Only
Other-WORD
Community Emergency Preparedness Survey - OMB Approved.docx
No
Paper Only
Other-WORD_Spanish Version
Community Emergency Preparedness Survey_Spanish_7.11.18.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Disaster Preparedness and Planning
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
500
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
500
0
0
0
0
500
Annual IC Time Burden (Hours)
40
0
0
0
0
40
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.