Information Collection

Cognitive Interviews to Evaluate Segments of the 2009 AHS Spanish Version

IC 184916 under ICR 200704-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ombAHSspanishtranslationenc1..doc	Other-Phase 1 (English)
ombAHSspanishtranslationenc2.doc	Other-Phase 1 (Spanish)
ombahsSpanishtranslation2enc1.doc	Other-Phase 2 (English)
ombahsSpanishtranslation2enc2.doc	Other-Phase 2 (Spanish)
ombAHSspanishtranslation.doc Cognitive Interviewing Plan	IC Document
ombahsSpanishtranslation2.wpd Update to Plan for Phase 2	IC Document

IC Title:

Cognitive Interviews to Evaluate Segments of the 2009 AHS Spanish Version

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Phase 1 (English)	ombAHSspanishtranslationenc1..doc	No	Paper Only
Other-Phase 1 (Spanish)	ombAHSspanishtranslationenc2.doc	No	Paper Only
Other-Phase 2 (English)	ombahsSpanishtranslation2enc1.doc	No	Paper Only
Other-Phase 2 (Spanish)	ombahsSpanishtranslation2enc2.doc	No	Paper Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 128

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 New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	128	0	0	0	0	0
Annual IC Time Burden (Hours)	192	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Cognitive Interviewing Plan	ombAHSspanishtranslation.doc	05/15/2008
Update to Plan for Phase 2	ombahsSpanishtranslation2.wpd	05/15/2008

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