Information Collection

QDRL Cross National Health Status English and Spanish Version

IC 182727 under ICR 200711-0920-004 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
OMB-QDRLComparative -Attachment 2.doc	Instruction
OMB-QDRL2007Comparative - Attachment 1.doc OMB-QDRL2007Comparative - Attachment 1	IC Document

IC Title:

QDRL Cross National Health Status English and 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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			OMB-QDRLComparative -Attachment 2.doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0164 Health and Demographic Survey Conducted in Probability Samples of the U.S. Population

FR Citation: 49 FR 37693

Number of Respondents: 60

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 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	60	0	0	0	0	0
Annual IC Time Burden (Hours)	60	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
OMB-QDRL2007Comparative - Attachment 1	OMB-QDRL2007Comparative - Attachment 1.doc	10/25/2007

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