Cognitive Interviews to Evaluate Segments of the 2009 AHS Spanish Version

Generic Clearence for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.