OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Questionnaire Bank

IC 187037 under ICR 200906-0920-017 · OMB 0920-0572.

Documents and Forms
Document Name
Document Type
Other-Interview
Other-Interview
Other-Interview
Other-Interview
Other-Interview
Other-Interview
Information Collection (IC) Details

View Information Collection (IC)

Questionnaire Bank
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Interview Health Message Testing System - Attachment 7 - Core Questions.doc Yes No Paper Only
Other-Interview Health Message Testing System - Attachment 8 - Activity-Task Questions.doc Yes No Paper Only
Other-Interview Health Message Testing System - Attachment 9 - Follow-Up Questions.doc Yes No Paper Only
Other-Interview REVISED Health Message Testing System - Attachment 4 - Demographic Questions.doc Yes No Paper Only
Other-Interview Health Message Testing System - Attachment 5 - Market Research Experience Questions.doc Yes No Paper Only
Other-Interview Health Message Testing System - Attachment 6 - Introductory Questions.doc Yes No Paper Only

Health Illness Prevention

 

6,000 0
   
Individuals or Households
 
   10 %

  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 6,000 0 0 0 0 6,000
Annual IC Time Burden (Hours) 3,000 0 0 0 0 3,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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