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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

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

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 %

	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

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