View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Community Opinions on Communication Strategies and Tools about Cancer and Environmental Hazards	Agency IC Tracking Number:	0923-0047-21FK

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	none	Recruitment	AttA.FocusGroupRecruitment.docx		Yes	No	Paper Only
Other-Focus group guide			AttC.Community_Fg_Facilitators_Guide.docx		Yes	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: 270	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	270	0	270	0	0	0
Annual IC Time Burden (Hours)	205	0	205	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Focus group information sheet	AttB.FocusGroupInfoSheet.docx	05/27/2021
genIC Request for Approval	ATSDR 0923-0047 GnrcClrncQualFdbkTmpltapprvlFrm_20210525.docx	05/27/2021
STARS determination	AttD.STARSDetermination.pdf	05/27/2021

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