View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	CDC Solve the Outbreak Mobile App	Agency IC Tracking Number:	0920-17XY

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	N/A	Solve the Outbreak (General Public version)	B_Screenshots-STO General Public.docx		Yes	Yes	Fillable Fileable
Form	N/A	Solve the Outbreak (Teacher version)	C_Screenshots_STO Teachers.docx		Yes	Yes	Fillable Fileable
Form	N/A	Solve the Outbreak (Student version)	D_Screenshots-STO Students.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	400	0	400	0	0	0
Annual IC Time Burden (Hours)	67	0	67	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Completed Fast Track Submission Template	Fast-track-template-STOSurvey03082017.docx	03/08/2017
Overview of Customized Survey Questions	A_Overview of Questions_03082017.DOCX	03/08/2017

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