NCHS Technology and Aging Pilot Survey

ICR 200405-0920-001

OMB: 0920-0648

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
7116
Migrated
ICR Details
0920-0648 200405-0920-001
Historical Active
HHS/CDC
NCHS Technology and Aging Pilot Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 07/01/2004
Retrieve Notice of Action (NOA) 05/06/2004
  Inventory as of this Action Requested Previously Approved
07/31/2007 07/31/2007
100 0 0
58 0 0
0 0 0

The Technology and Aging Pilot Survey will be conducted by personal telephone interviews among a convenience sample of persons with disabilities. The survey will test a newly developed instrument that can be incorporated into national health and aging surveys to measure the use of technologies and the home environment among elderly persons with disabilities.

None
None


No

1
IC Title Form No. Form Name
NCHS Technology and Aging Pilot Survey

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100 0 0 100 0 0
Annual Time Burden (Hours) 58 0 0 58 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/06/2004


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