ICR Documents

Supporting Statement A Document Date Uploaded 1 - SSA PCCPHE Extension 20200108.docx 02/18/2020 Supporting Statement B Document Date Uploaded 1 - SSB PCCPHE Extension 20200108.docx 02/18/2020 Supplementary Documents Title Document Document Type Date Uploaded Authorizing Legislation Att1 Authorizing Legislation.pdf Supplementary Document 02/18/2020 60d FRN - published Att2 60 day Federal Register Notice.pdf Supplementary Document 02/18/2020 Map of US Poison Control Centers Att3 Map of United States Poison Centers.pdf Supplementary Document 02/18/2020 CDC-AAPCC Data License Agreement Att4 CDC-AAPCCDataLicAgremt__2016_signed.pdf Supplementary Document 02/18/2020 Step-by-Step Use of Generic Clearance Att5 Step-by-Step How to Use the Generic Clearance.docx Supplementary Document 02/18/2020 Advance Notification Email for OMB - sample Att6 Advanced Notification Email for OMB.docx Supplementary Document 02/18/2020 GenIC Request for Approval - Template Att7 GenIC Rqst Apprvl Form PCCPHE 20200108.docx Supplementary Document 02/18/2020 Consent/Assent Forms - sample Att8 Sample Consent and Assent Forms.docx Supplementary Document 02/18/2020 Adult Questionssaire - sample Att9 Sample Questionnaire Adult 20200108.docx Supplementary Document 02/18/2020 Adolescent Questionnaire - sample Att10 Sample Questionnaire Adolescent 20200108.docx Supplementary Document 02/18/2020 Parent Questionnaire - sample Att11 Sample Questionnaire Parent 20200108.docx Supplementary Document 02/18/2020 Burden Memo Att12 Burden Memo PCCPHE 20200108.docx Supplementary Document 02/18/2020 Research Determination Att13 NCEH Research and PRA Determination PCCPHE 20200108.pdf Supplementary Document 02/18/2020 Dataset for Questionnaire - example Att14 Example Dataset for Questionnaire.xlsx Supplementary Document 02/18/2020 Privacy Impact Assessment Att15 Privacy Impact Assessment PCCPHE 20200108.pdf Supplementary Document 02/18/2020 Justification - Quarterly burden 2020Q1 0920-1166 Change Request Justification FY2020 Q1.docx Justification for No Material/Nonsubstantive Change 01/23/2020 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received