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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
4-Poster Deer Treatment Device Acceptability Survey
Agency IC Tracking Number:
0920-1150-20KS
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
none
CT survey
CT Survey_revised for ICRO.pdf
Yes
Yes
Fillable Fileable
Form
none
NY Survey
NY Survey_revised for ICRO.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Illness Prevention
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,500
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
4,500
0
4,500
0
0
0
Annual IC Time Burden (Hours)
300
0
300
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
List of recruitment areas
1_Recruitment areas.docx
02/27/2020
Reminder postcard
3_Survey reminder postcard.pptx
02/27/2020
Survey video
5_Survey video.pptx
02/27/2020
Thank you letter
6_Thank you letter.docx
02/27/2020
Study website
7_CDC study website.docx
02/27/2020
Study protocol
8_4-Poster Acceptability_protocol_v1_011520.docx
02/27/2020
Research determination
9_Human subjects determination.docx
02/27/2020
Supporting statement A
SSA.docx
02/27/2020
Supporting statement B
SSB.docx
02/27/2020
Survey invitation
2_Survey invitation postcard.pptx
03/02/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.