[NCEZID] CryptoNet Case Report Form

ICR 202504-0920-005

OMB: 0920-1360

Federal Form Document

Forms and Documents

Document Name	Status
CryptoNet Case Report Form Form and Instruction	Modified
Change Request Memo - EO14168 Template_CryptoNet_3.27.2025_FINAL.docx Justification for No Material/Nonsubstantive Change	2025-04-03
Att E2_Privacy Impact Assessment.pdf Supplementary Document	2024-12-17
Att E_Privacy Impact Assessment_DCIPHER SaaS.pdf Supplementary Document	2024-12-17
Att D_Human Subjects Determination.pdf Supplementary Document	2024-12-17
Att B_ Published Federal Register Notice.pdf Supplementary Document	2024-12-17
Att A_Section 301 of the Public Health Service Act (42 USC 241) (1) (1) (1).pdf Supplementary Document	2024-12-17
SSB_CryptoNet_2024 revision package - CLEAN.docx Supporting Statement B	2024-12-17
SSA_CryptoNet_2024 revision package_CLEAN_final.docx Supporting Statement A	2025-02-25

IC Document Collections

IC ID	Document Title	Status
248663	CryptoNet Case Report Form Form and Instruction	Modified