Information Collection

Parent/caregiver Pre-test Questionnaire

IC 188211 under ICR 200903-0990-001 · OMB 0990-0337.

Documents and Forms

Document Name Document Type
0990-BodyWorks_pretest 1 29 09_parent.pdf Other-Questionnaire

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Parent/caregiver Pre-test Questionnaire	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
Other-Questionnaire			0990-BodyWorks_pretest 1 29 09_parent.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 171	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	171	171
Annual IC Time Burden (Hours)	86	86
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.