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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
"Lyme and other Tickborne Diseases Knowledge, Attitude, and Practice Surveys"
Agency IC Tracking Number:
0920-1050-22DA
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
0920-1050
A Survey of NJ Mosquito Control Agencies Regarding the Management of Ticks and Tick-borne Disease
Att 2 2022 NJ MCA Survey Screenshots.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1050
Survey of NJ Local and County Public Health Agencies Regarding Tick and Tick=borne Disease Managment
Att 3 2022 NJ LCHD Survey Screenshots.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems
FR Citation:
86 FR 6591
Number of Respondents:
115
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
115
0
115
0
0
0
Annual IC Time Burden (Hours)
39
0
39
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Email Invitation and Reminder text
Att 4 2022 NJ SURVEYS - Email Invitation and Reminder text.docx
03/09/2022
Supporting Statement A
Supporting Statement A_GenIC_TickControlSurvey_NJ_021822.docx
03/09/2022
Supporting Statement B
Supporting Statement B_GenIC_TickControlSurvey_NJ_021822.docx
03/09/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.