Information Collection

Discussion guide for focus groups

IC 189115 under ICR 200902-0920-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment 1b.doc	Instruction
Attachment 1a.doc Birth certificate form to begin discussion	IC Document
Attachment 1c.doc Introduction to cognitive interview	IC Document
Attachment 2.doc Invitation to participate	IC Document
QDRL-OMB-DVS Collection of Birth Certificate Data-letter.doc Justification	IC Document

IC Title:

Discussion guide for focus groups

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			Attachment 1b.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 0920-0164 Health and Demographic Surveys Conducted in Probability Samples of the US Population

FR Citation: 49 FR 37693

Number of Respondents: 74

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	74	0	0	0	0	0
Annual IC Time Burden (Hours)	86	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
Birth certificate form to begin discussion	Attachment 1a.doc	05/07/2009
Introduction to cognitive interview	Attachment 1c.doc	05/07/2009
Invitation to participate	Attachment 2.doc	05/07/2009
Justification	QDRL-OMB-DVS Collection of Birth Certificate Data-letter.doc	05/07/2009

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