View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	ArboNET Needs Assessment	Agency IC Tracking Number:	0920-1154-22CJ

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	0920-1154	ArboNET Needs Assessment	Attachment 2. ArboNET Needs Assessment Information Collection.docx		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: 60	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	60	0	60	0	0	0
Annual IC Time Burden (Hours)	60	0	60	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
EMAIL to Solicit ArboNET Surveillance Coordianor	Attachment 1. ArboNET Needs Assessment Invitation to Participate.docx	02/01/2022
Human Subject Determination	ArboNET Needs Assessment_Human Subjects Determination.docx	02/01/2022
Supporting Statement A	SSA (0920-1154)_ArboNET Needs Assessment.FINAL.docx	02/01/2022
Supporting Statement B	SSB (0920-1154)_ArboNET Needs Assessment.FINAL.docx	02/01/2022

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