Information Collection Request
Information Collection on Cause-Specific Absenteeism in Schools
ICR 202108-0920-002 · OMB 0920-1039 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 0920-1039 Household Component - Household Study Form B (Day 0, 7, and 14) |
Form | New | Repair queued |
| Form 0920-1039 Household Component - Household Study Form B |
Form | Modified | Missing upstream |
| Form 0920-1039 Student Component - Household Study Form A |
Form | Modified | Missing upstream |
| 18) |
Form | Modified | Repair queued |
| Form 0920-1039 Student Component - ORCHARDS Telephone Screen |
Form and Instruction | Modified | Repair queued |
 OMB changes document with consents 8.17.21.docx |
Supplementary Document | Uploaded 2021-08-26 | Repair queued |
 20200406 REDCap PIA signed.pdf |
Supplementary Document | Uploaded 2021-08-16 | Repair queued |
| Att C3 - consent_assent forms.docx |
Supplementary Document | Uploaded 2021-08-16 | Repair queued |
| Att C3a Assent 7 - 14.pdf |
Supplementary Document | Uploaded 2021-08-16 | Repair queued |
| Att C1 - School District Approval Letter.pdf |
Supplementary Document | Uploaded 2021-08-16 | Repair queued |
| Att. D4 - orchards newspaper ad.pdf |
Supplementary Document | Uploaded 2017-10-27 | Repair queued |
| Att D2 - Recruitment Flyer_teenager.docx |
Supplementary Document | Uploaded 2021-08-16 | Missing upstream |
| Att D3 - Recruitment Flyer_kid.docx |
Supplementary Document | Uploaded 2021-08-16 | Missing upstream |
| Att D1 - participant packet.pdf |
Supplementary Document | Uploaded 2021-08-02 | Repair queued |
| Att C5 IRB Approval_22Jan2021.pdf |
Supplementary Document | Uploaded 2021-08-16 | Repair queued |
| Att C6 -CDC IRB Deferral.pdf |
Supplementary Document | Uploaded 2021-08-16 | Missing upstream |
| Published 60-day FRN.pdf |
Supplementary Document | Uploaded 2021-08-02 | Missing upstream |
| Non-Substantive Change 0920-1039 ARI and Influenze Survillance Form.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2015-12-28 | Repair queued |
| SupStaA_WI School Absenteeism_final.docx |
Supporting Statement A | Uploaded 2021-08-16 | Missing upstream |
| Att A3- Sec 301 PHSA (42 USC 241).pdf |
Supplementary Document | Uploaded 2021-08-02 | Missing upstream |
| Att A2- CFR part 70.pdf |
Supplementary Document | Uploaded 2021-08-02 | Repair queued |
| Att A1- Sec 361 PHSA (42 USC 264).pdf |
Supplementary Document | Uploaded 2021-08-02 | Repair queued |
| SupStaB_WI School Absenteeism_final.docx |
Supporting Statement B | Uploaded 2021-08-16 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 248917 |  Household Component - Biospecimen Collection (Day 0, 7 and 14) |
Instruction | New | |
| 248916 | Household Component - Household Study Form B (Day 0, 7, and 14) |
Form | New | |
| 248914 | Household Component - Biospecimen Collection (Day 7 and 14) |
Instruction | New | |
| 228818 | Household Component - Household Study Form B |
Form | Modified | |
| 228817 | Student Component - Biospecimen Collection (Day 0) |
Instruction | Modified | |
| 228816 | Student Component - Household Study Form A |
Form | Modified | |
| 212417 | 18) |
Form | Modified | |
| 212402 | Student Component - ORCHARDS Telephone Screen |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1039 |
| Type of Information Collection | Reinstatement with change of a previously approved collection |
| Previous ICR Reference No | 201710-0920-016 |
| Agency Tracking No | 0920-1039 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |