View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Ebola_West Africa_2014	Agency IC Tracking Number:	14AZY

IC Status: Unchanged

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 and Instruction	none	Observation Guide	Appendix 2. Ebola_Burial Practices Observation Guide.docx		No		Paper Only
Form and Instruction	none	Field Guide	Appendix 1 Ebola_Burial Practices Field Guide for In-depth Interviews.docx		No		Paper Only
Form and Instruction	none	Focus Group Guide	Appendix 3 Ebola_Burial Practices Focus Group Guide.docx		No		Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 113	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	113	0	0	0	0	113
Annual IC Time Burden (Hours)	105	0	0	0	0	105
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Letter of Invitation	LOI.pdf	09/29/2014
Requst Letter	2014020-XXX_Ebola_WestAfrica3[1].docx	10/02/2014

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