View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Message Testing: Radiation Emergencies and Cancer Risk	Agency IC Tracking Number:	0920-0572-20OV

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 and Instruction	0920-0572	Message Testing Survey	AttA Word Survey 20200602.docx		Yes	Yes	Fillable Fileable
Other-Online Screenshot			AttB Online Survey 20200602.pdf		Yes	Yes	Fillable Fileable

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: 600	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	600	0	600	0	0	0
Annual IC Time Burden (Hours)	150	0	150	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
HMTS Request Template	0 - HMTS Rqst GenIC RadiationEmrgncs CancerRisk 20200430.pdf	06/02/2020
Protocol	AttC Protocol 20200430.docx	06/02/2020
IRB approval	AttD CDC 7275 Exempt Granted Memo 20200418.pdf	06/02/2020
List of Attachments	0 - LIst of Attachments 20200430.docx	06/02/2020

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