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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Feasibility of Publicly Funded Tick and Tick-Borne Disease Management Programs in NJ (high incidence state)
Agency IC Tracking Number:
0920-1050-22CN
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
0920-1150
A survey of NJ Local and County Public Health Agencies Regarding Tick and Tick-borne Disease Managment
2022 NJ LCHD Survey Instrument.pdf
Yes
Yes
Fillable Fileable
Form
0920-1150
A Survey of NJ Mosquito Control Agencies Regarding the Management of Ticks and Tick-borne Disease
2022 NJ MCA Survey Instrument.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:
115
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
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
Supporting Statement A
Supporting Statement A_GenIC_TickControlSurvey_NJ_021822.docx
02/28/2022
Supporting Statement B
Supporting Statement B_GenIC_TickControlSurvey_NJ_021822.docx
02/28/2022
Authorizing Legislation
Att 1. Section 301 of the Public Health Service Act (42 USC 241).pdf
02/28/2022
NJ MCA Survey (screenshots)
Att 2 2022 NJ MCA Survey Screenshots.pdf
02/28/2022
NJ LCHD Survey (screenshots)
Att 3 2022 NJ LCHD Survey Screenshots.pdf
02/28/2022
Email Invitation
Att 4 2022 NJ SURVEYS - Email Invitation and Reminder text.docx
02/28/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.