Proxy Survey Web Mode

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OMB Control # 0920-XXXX

Expiration Date XX/XX/XXXX

Public reporting burden of this collection of information is estimated to average 3 minutes per response, including the time for reviewing instructions and completing and reviewing the collection of information. An agency may not conduct or sponsor this survey, and a person is not required to respond to a collection of information, unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA 0920-XXXX.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
File Title	Proxy Survey Web Mode
Author	Sophie Mir
File Modified	0000-00-00
File Created	2021-01-21