OMB Control Header and Burden Statement

Att 9 - PRA Burden Statement Screenshot.pdf

[OPHDST] Generic Clearance for the Collection of Minimal Data Necessary for Case Data During an Emergency Response

OMB Control Header and Burden Statement

OMB:

Document [pdf]
Download: pdf | pdf
†‡ˆ‰€Š‹€Œˆ‹€Ž‘Š’’ˆ“”•€–€Œ—Œ

z{|}{}~€‚ƒ~€„…

0123451604238196
3
1


36615

2
00











!
"

#
#
$%&
'
3
()12
*

2 +,-./01.213
1456781

36615
3945:123451624;963*
162*;123
<=2*
6;24
a

5:
215::3
1
15:2*
3;
1:15::
2
35
1;;4;312
123452445246429
1><81

36615
4

1*23
;963*
162*13
53
122*
64161212
14512345166

6466
235941234519421?@AB4;
45:31354
:
(32*1:3
1
445:323452*12;4
1
34*
162*2*
1224C
315<D*

:3
1
15:45:32345356:

359
234:3
1
1*144513:3
1
.5,E8'F=G,EH
944:945
429
1>1*1I<463H15:
545359
23445:323451*16
1:;4345353<

bcdefghfigejkglmfnohfplqdhclkr
=59431;*32)a +st,/01.213
14567
'
3
()12
*

2a +,-./01.213
14567
81

36615
2121264161212
115:2
324316;963*
162*:
;12
52<J41661(15:
3612345;
39(*3*
:3
1
15:45:3234529

;42
:<D*
*
162*:
;12
52(4>(32**
162*1
;43:
161941243
1*4;32161
15:42*
;125
243
22*
3594123455

:
:2445324145246115:;

522*

KBLMKN@OPB:3
1
15:45:32345
352*
345323
<
Q
162*:
;12
5216454239881942
213545:323454(
1521>2*
942*
(*46
452<8845324
1942,.5492*

RMNST@OPBU:3
1
15:45:32345122*
512345166

6<D*33;421522
;*
6;;42
22*
*
162*49
35:33:1645323
15:2*
512345<)4664(353215:1:1
:
853234511

36615
1;2
3594123452*12
;963*
162*49831615
245:
215:(*

:3
1
1
43531*4(2*
159
;

52
:115:(*3*34;
1
42*
1363;12
:<D*3359412345356:
V
(*43199
2
:W2*
:
431;*31635316115:
;3:
346433*112
323H
(*

2*
1
199
2
:W2*
3
431;*3:3239234549:3
1
H15:
*4(2*
1
199
2
:W2*
4
496353163665
15:1


3
:<

XYZ![#Z!\Z][#^_`]]!$%&
uBLMKN@OPBUvSAB@ABAU@RwUxMRwSNSMRA
I1*212
42
324
2641661(15:6
94
(*3*:3
1
15:45:3234529

;42
:<

yMNST@OPBUvSAB@ABAU@RwUxMRwSNSMRA
D*
8453649
212
15:D
324316I;3:
3464332
15:883:
52392*
6324954238196
:3
1
15:
45:32345<
|{~

]^_`^`abcdefacgh

ijklcmncoknpcqrstpmuukvwpxcycozo

IJKLMNOPQJRSTUJOUJUROVWRXLVWTNTLVU
YLNTZOPQJRSTUJOUJUROVWRXLVWTNTLVU
=! %&"!2"8!$ %3%*""$!3&2$%3
+!#%"$%,$8"-:&!2!"-!!
&!"2"#$!"-!%%2*%$&! %&!2 "-!
!"$"$!"$*!-!!0
:&!2!"$$'!0
?*%$&! %&!2 "-!%%!$8"- $*
&!2!"&:&!,*!-!$%%0
6&$$8"- $$!%!&!"!8
*"! 72"!#!2"! 0
6&!%$8$! !$$& '!!#!",
,! "0

 !"!"$2!" %%,$!$) *%!
$8"- $0
! -$"3-! "!3%!"
$$#$ %--$$!"&! $*"! 7
&!"2*%$&! %&&"! 0
6&!%$8*[\5$! !$$$
2 !!#!",,! "0

01234467894
29824

917
79737
9747

!"#!$%%!&"'&&!( $ %($) *%!$! !+"#!$%%!+,!-.((++/01&!!
"#!$%%!2"!3*43555&! %&!2 "-!' &!"! $! !!2"!&!$"%%
--$$!06&"'&((++3"!!$#!!&!! 7!!22!2%!&! %&,!8!9-!"$8"-&! %&
&"! 0
2"'"-"!2$*%!8" $ %"#!$%%!32"!#!$3"%8$8!$$8!$$$"!
8$&!8%%:$'!!";
!!"8"<%* %=! %&.<=/>
( $ %!!"8"&"$$! !?"!#!$=! %&?"-$.(?=?/>
( $ %!!"8"@-!"'$'A$18!$$! !.(@A1/>
( $ %!!"8"@#$"-!%=! %&.(@=/>
( $ %!!"8"=1BC91+3B$"%=!2 $$3+636D?"!#!$.(==+6?/>
( $ %!!"8"1--$E$F!2$"",$! !.(1F/>
( $ %1$!8"G2 $ %+ 8!,=! %&.(1G+=/0
6&!!2"'"-%%*"!:$&&!$%8+!6!""$"$%@2$!-$%'$!!"-$!:&$&$$
"!2"!%%3!3!""$"$%2*%$&! %&!2 "-!"! $ %%,$) *%!06&!$%8+!
6!""$"$%@2$!-$%'$*"$''!&!"$! !"#!$%%!!H2!"$&!&! %&!2 "-!
!!"-$!:& ,2!8 &%*!$%!$ $ %$)$0
((++"!!$#!32"!!32"#$!  $ %$) *%!$! !2"'"-"06&!2"'"-!
&!! &!8%%:$';
"!'$E!$! !*"! 7>
"7&!2"! 8$! !&!!3"!'$ %3 $ %%!#!%>
$!$8,'!'"2&$"! 8!"$8"-!!$$- 7!">
&!%2!%%2*%$&! %&!2 "-!*!!""%$! !*,$!$8,$''"2-"$7>
!#% !8$! !"%$#$$!0

`^a

„…†‡…‡ˆ‰Š‹ŒˆŠŽ

0134567895


‘’“Š”•Š–’•—Š˜™š›—”œœ’ž—ŸŠ Š–¡–


!"##$%&%''())*"$#"&"+$""*
"",&*
-##.,""*"+$"$""/
'#.012334567%&%''())$%./

89:;<36=3>=:?>25>"@>>9>??>4?3954>=?:;<36=3>=
:?>25>*A%%%B(B/
C4D>=E2?65:4:;3>45"7$%&%''())/

66FGGHIJ5
KLMN3LIK

 $%#&.**-$%& !#!*B(B"&%"&,"O"&%"+$%
77''())/ 7+%(P"O"Q"""!*B(B"%$"&%
"#".+''())7!"
$,7%"!*",#.*%"&%RS#".+7
#"$%#%$"",T"&/U%&%%",#"R.""""!*B(B"
,T"&%''())$%#&"$#"+$,
%""
"7
#*"O
-$%&,$%", /

VWXYZ[\W]^Z_`aYZb]XcYdee`fgYZ`fhZiijbb

klmnopnqlrstuvnqwxpyzwxpsn{|xpwxpn}t~p|€€wrup


%7$ ., %''())$##$"#"‚
#"$/
ƒP

…ˆ

‚ƒ„‚„…†‡ˆ‰Š…‡‹Œ

Ž‡‘’‡“’”‡•–—˜”‘™™š›”œ‡‡“ž“

z3<24?B715{7s4{:?53|123457487t1<:7=>?@:36615A:

}Sgc~cSTST\adT_cTbTSf^aS_]dST_H
maF

 !"#$%&'()"*&'"+%$)",''-)'./
012345167042383196:7;3<:1<:<7=>?@:36615A:7=B<2:CD

EFGHIJKILIMKNOPQRSSTUVIWXWYXKIKMZH[\R]^S_RST`^]aTb\S__STbSTbcSTSScad`KIcST]RRTb
e_SSeTaSS\]c_TSf_STeK\]bTa_SS\aT]ceTaKIcST]bSSTab_Sa
\aT]cH[\SST_]a\ScbdSgST`ST]_STe_\ST`QSST`a]_e`\ST`TacSTSTST`\aTaaeTa_cRST`Ta
dSgST`\__STbSTbcSTHhT`T_cT_Ta]_RTeTaRTSTi]SaRTa__STbSTbcST]TSaSR
_]TdSaEFG_TT]c^HjTa_ccT`aST`\S^]aTScT\R_b\S__STbSTbcSTeST_]aST`]``STba]_ST`
\S^]aTklUlXh[jUmmRlT_Ebf_nYoIIlSbTmaPeFjpKYLNehTeq`SWIWKJh[[VmhOIJKILIMKNZHr

s353C167;12170:A:<<1?B784?7t1<:7;1217;>?35u7157vC:?u:5AB7w:
File Typeapplication/pdf
File TitleWhat is Case Surveillance_ _ CDC
Authorklg6
File Modified2024-08-12
File Created2024-08-12

© 2024 OMB.report | Privacy Policy