General Public - Case Investigation Form

SARS-CoV-2 Epidemiologic Data Collections

OMB: 0920-1297

IC ID: 241628

Documents and Forms
Information Collection (IC) Details

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General Public - Case Investigation Form
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Case Investigation Form 3. Case Investigation Form_instrument_OMB_updated_04.23.20.docx NA Yes Yes Fillable Fileable

Disaster Management Emergency Response

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 92812

300 0
   
Individuals or Households
 
   50 %

  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 300 0 0 0 0 300
Annual IC Time Burden (Hours) 300 0 0 0 0 300
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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