Information Collection

2008 and 2009 Medical Expenditure Panel Survey - Insurance Component Prescreener Questionnaire

IC 182459 under ICR 200710-0935-001 · OMB 0935-0110.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0110 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form #1 2008 and 2009 Medical Expenditure Panel Survey - Insurance Component Prescreener Questionnaire	Form
Form #1 Prescreener CATI Questionnaire ATTACHMENT P prescreener.doc	Form

IC Title:

2008 and 2009 Medical Expenditure Panel Survey - Insurance Component Prescreener Questionnaire

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	Form #1	Prescreener CATI Questionnaire	ATTACHMENT P prescreener.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 31,319

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions, Farms

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	31,319	31,319
Annual IC Time Burden (Hours)	2,957	2,957
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.