Information Collection Request

[NCEZID] EMERGENCY - B. multivorans Ice Machine Multistate Investigation

ICR 202404-0920-002 · OMB 0920-1430 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-1430 can be found here:

Forms and Documents

Document Name	Status
Burkholderia multivorans Outbreak Investigation Case Report Form Form	New
Burkholderia multivorans Outbreak Investigation Case Report Form Form	New
Supporting Statement A_B multivorans.docx Supporting Statement A	2024-04-04
Supporting Statement A_B multivorans.docx Supporting Statement A	2024-04-04
Attachment 4-PIA REDCap.pdf Supplementary Document	2024-04-04
Attachment 4-PIA REDCap.pdf Supplementary Document	2024-04-04
Emergency Request Memo_B multivorans 2024 national call for cases dbj.pdf Supplementary Document	2024-04-02
Emergency Request Memo_B multivorans 2024 national call for cases dbj.pdf Supplementary Document	2024-04-02
Attachment 5-Human Subjects Determination.pdf Supplementary Document	2024-04-02
Attachment 5-Human Subjects Determination.pdf Supplementary Document	2024-04-02
Attachment 1-Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document	2024-04-02
Attachment 1-Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document	2024-04-02
Supporting Statement B_B multivorans 2024 national call for cases.docx Supporting Statement B	2024-04-02
Supporting Statement B_B multivorans 2024 national call for cases.docx Supporting Statement B	2024-04-02

IC Document Collections

IC ID	Document Title	Status
266503	Burkholderia multivorans Outbreak Investigation Case Report Form Form	New
266503	Burkholderia multivorans Outbreak Investigation Case Report Form Form	New

ICR Details

Status	Active
Agency/Subagency	HHS/CDC
OMB Control No	0920-1430
Type of Information Collection	New collection (Request for a new OMB Control Number)
Agency Tracking No	0920-24EK
Date Submitted to OIRA	2024-04-04
Requested Expiration Date	2024-04-05