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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Undetermined cause of Acute Flaccid Myelitis, multiple states, United States, 2018
Agency IC Tracking Number:
0920-1011-19BHA
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
0920-1011
Acute Flaccid Myelitis Case Questionnaire - English
Appendix 1. Questionnaire - English.docx
NA
No
Fillable Printable
Form and Instruction
0920-1011
Acute Flaccid Myelitis Case Questionnaire - Spanish
Appendix 2. Questionnaire - Spanish.docx
NA
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Emergency Response
Privacy Act System of Records
Title:
Epidemic Investigation Case Records - 09-20-0113
FR Citation:
51 FR 42466
Number of Respondents:
210
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
210
0
0
0
0
210
Annual IC Time Burden (Hours)
210
0
0
0
0
210
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Letter of Invitation - MN
LOI-MN.AFM.pdf
06/12/2019
Letter of Invitation - Concurrence_Multiple States
Concurrence emails compilation.pdf
06/12/2019
Burden Table - Email
0920-1011 Burden Table - Email.msg
06/12/2019
EEI GenIC Request
2019003-XXX AFM_multi_REVISED 13JUN2019.docx
06/13/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.