View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Assessment of Awareness and Use of Epidemiology and Analysis Program Office Products	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Awareness and Use of EAPO Products	EAPO Assessment - Attachment H - Online Survey Screen Shots_2 13 13.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 342	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	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	342	0	0	0	0	0
Annual IC Time Burden (Hours)	143	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	EAPO Assessment - Statement_A__02 13 2013.doc	02/14/2013
Supporting Statement B	EAPO Assessment - Statement_B_02 13 2013.docx	02/14/2013
Att A - Community Guide Sample	EAPO Assessment - Attachment A Community Guide Sample.pdf	02/14/2013
Att B - MMWR Weekly Sample	EAPO Assessment - Attachment B MMWR Weekly Sample.pdf	02/14/2013
Att C - MMWR Supplement Sample	EAPO Assessment - Attachment C MMWR Serial Sample.pdf	02/14/2013
Att D - CDC Vital Signs Sample	EAPO Assessment - Attachment D CDC Vital Signs Sample.pdf	02/14/2013
Att E - CDC Science Clips Fact Sheet	EAPO Assessment - Attachment E Science Clips Fact Sheet.pdf	02/14/2013
Att F - Epi Info Fact Sheet	EAPO Assessment - Attachment F Epi Info 7 Fact Sheet.pdf	02/14/2013
Att G - EAPO Assessment - Word	EAPO Assessment - Attachment G - EAPO Assessment Instrument.docx	02/14/2013
Att I - Email Notification	EAPO Assessment - Attachment I- Notification email.docx	02/14/2013
Att J - Email Reminder	EAPO Assessment - Attachment J - First reminder message.docx	02/14/2013
Att K - Second Reminder	EAPO Assessment - Attachment K - Second reminder message.docx	02/14/2013
Att L - Third Reminder	EAPO Assessment - Attachment L - Third reminder message.docx	02/14/2013

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