0920-1352 Partner Planning Sheet

Form Approved

OMB Approval No. 0920-1352

Expiration Date: 10/31/2021

Partner Planning Sheet

Partner Detail

1. Partner name

2. Partner type

3. Access and functional needs(AFN) group represented

4. Pphase of partner engagement

5. Partner engagement during the response addressed disabilities and others with AFN

6. Recovery efforts following the response coordinated with partner

7. Partners supported in NPIs

8. Participation in jurisdictional risk assessment

9. Communication support (public information and warning)

10. Exchange of information between governmental agencies (information sharing)

11. Participation in training

12. Participation in exercises incidents/events

Public reporting burden of this collection of information is estimated to average 150 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 (0920-1352).