Information Collection

Highly Pathogenic Avian Influenza (HPAI) Emergency Response Responder Feedback Survey - State

IC 218014 under ICR 201508-0579-004 · OMB 0579-0377.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0579-0377 can be found here:

Documents and Forms

Document Name Document Type
2015 survey.pdf Other-survey
2015 Fast Track Submission.docx Fast Track Template IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Highly Pathogenic Avian Influenza (HPAI) Emergency Response Responder Feedback Survey - State	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 9 CFR 1-199 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			2015 survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Template	2015 Fast Track Submission.docx	08/31/2015

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