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Federal forms, ICRs, and supporting documents

Information Collection

Ebola Virus Disease Case Contact Questionnaire

IC 213620 under ICR 201501-0920-017 · OMB 0920-1033.

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

View Information Collection (IC)

Ebola Virus Disease Case Contact Questionnaire 0920-15CN
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-15CN Attachment L_Ebola Virus Disease Case Contact Questionnaire Attachment L_Ebola Virus Disease Case Contact Questionnaire.doc Yes No Fillable Printable

Health Illness Prevention

Ebola Emergency Investigation Case Records System Notice  51 FR 42166

50 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 50 0 0 0 0 50
Annual IC Time Burden (Hours) 4 0 0 0 0 4
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.