Information Collection

Hints 2007

IC 179784 under ICR 200704-0925-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 HINTS 2007	Form
1 J Appendix J - Extended Instrument.pdf	Form
2 I Appendix I - Screening Instrument.pdf	Form
Appendix N - Letters for Mail Sample.pdf Appendix N - Letters for Mail Sample	IC Document

IC Title:

HINTS 2007

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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	1	J	Appendix J - Extended Instrument.pdf		Yes	Yes	Paper Only
Form	2	I	Appendix I - Screening Instrument.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,140

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,140	4,140
Annual IC Time Burden (Hours)	1,380	1,380
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Appendix N - Letters for Mail Sample	Appendix N - Letters for Mail Sample.pdf

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