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Federal forms, ICRs, and supporting documents

Information Collection

Individual Questionnaire

IC 223311 under ICR 201609-0920-018 · OMB 0920-1137.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Individual Questionnaire
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction NA Zika Investigation - Individual Interview Form SPANISH Att H - Individual questionnaire SPANISH.doc NA No   Paper Only
Form and Instruction NA Zika Investigation - Individual Interview Form ENGLISH Vector-Control Initiatives in PR - Individual questionnaire 26 Sept 2016.docx NA No   Paper Only

Health Public Health Monitoring

09-20-0113 Epidemic Investigation Case Records Systems Notice  51 FR 42466

500 0
   
Individuals or Households
 
   0 %

  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 1,000 0 0 0 0 1,000
Annual IC Time Burden (Hours) 500 0 0 0 0 500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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