Form Approved OMB
Approval No. 0920-xxxx Expiration
Date: xx/xx/xxxx
FE, FSE or incident
a. Participating partners
b. HHS regional participation (select all that apply)
Public reporting burden of
this collection of information is estimated to average 6
minutes per
response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information. An
agency may not conduct or sponsor, and a person is not required to
respond to a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this
burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to
CDC/ATSDR Information Collection Review Office, 1600 Clifton Road
NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Garcia, Albert (CDC/DDPHSIS/CPR/OD) |
File Modified | 0000-00-00 |
File Created | 2022-03-03 |