Information Collection

Formative Research on Issues Related to the Use of Mass Media in African-American Women, Phase II

IC 46723 under ICR 200701-0920-003 · OMB 0920-0738.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Part B supptg stat Formative Research on Issues Related to the Use of Mass Media in African-American Women, Phase II	Form and Instruction
Part B supptg stat Recruitment Screener Supporting Statement part B.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 3 CFR 241.301

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Part B supptg statement with all attachmts	Recruitment Screener	Supporting Statement part B.doc		Yes	Yes	Printable Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 150

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	13	13
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.