Information Collection

Demographic-Health Questionnaire - 24HR Dietary Recall Comparison Study

IC 190235 under ICR 200908-0925-001 · OMB 0925-0605.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0605 can be found here:

Documents and Forms

Document Name Document Type
Form 5 Demographic-Health Questionnaire - 24HR Dietary Recall Comparison Study Form and Instruction
5 Demographic-Health Qx - Comparison Study Attach6 - 24HR comparison demographic qx.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Demographic-Health Questionnaire - 24HR Dietary Recall Comparison Study	Agency IC Tracking Number:

Is this a Common Form?		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
Form and Instruction	5	Demographic-Health Qx - Comparison Study	Attach6 - 24HR comparison demographic qx.doc		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 540	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	540	540
Annual IC Time Burden (Hours)	72	72
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.