Information Collection

Attachment B8. Demographic Survey (Parent)

IC 179831 under ICR 200704-0920-003 · OMB 0920-0747.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0747 can be found here:

Documents and Forms

Document Name Document Type
Attachment B8. Demographic Survey (Parent) Form and Instruction
Demographic Survey Attachment B8 Parent Demographic Survey reduced.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Attachment B8. Demographic Survey (Parent)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Demographic Survey	Attachment B8 Parent Demographic Survey reduced.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136 - Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 961	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	961	961
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.