View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Improving Processes for Identifying and Reporting Disaster-Related Deaths CDC Guidance Knowledge Assessment	Agency IC Tracking Number:	0920-22ID

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	Survey	0920-22ID	Attachment A- Survey Questionnaire.docx		Yes	Yes	Fillable Fileable
Form and Instruction	Focus Group Moderator Guide	0920-22ID	Attachment C- Focus Group Moderator Guide.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Disaster Management

Subfunction: Disaster Preparedness and Planning

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,871	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	2,871	0	2,871	0	0	0
Annual IC Time Burden (Hours)	529	0	529	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
SSA	DRD-ASSESS_SSA.docx	08/15/2022
Attachment B- Survey Questionnaire (Web)	Attachment B- Survey Questionnaire (Web).docx	08/15/2022
SSB	DRD-ASSESS_SSB.docx	08/15/2022
Survey Invitation Letter	Attachment D- Survey Invitation Letter.docx	08/15/2022
Survey Reminder Postcard	Attachment E- Survey Reminder Postcard.docx	08/15/2022
Focus Group Invitation Email	Attachment G- Focus Group Invitation Email.docx	08/15/2022
Focus Group Reminder Email	Attachment H- Focus Group Reminder Email.docx	08/15/2022
Focus Group Consent Form	Attachment I- Focus Group Consent Form.docx	08/15/2022
Focus Group Segmentation	Attachment J- Focus Group Segmentation.docx	08/15/2022
Research Determination NORC	Attachment M - Research Determination NORC.pdf	08/15/2022
PIA	Attachment K- Privacy Impact Assessment.pdf	08/15/2022
Research Determination STARS	Attachment L - Research Determination STARS.pdf	08/15/2022

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