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Federal forms, ICRs, and supporting documents

Information Collection

Field Test Survey Instrument (Web and Telephone)

IC 191178 under ICR 200911-0920-001 · OMB 0920-0845.

Documents and Forms
Document Name
Document Type
Other-Web Survey
Other-Telephone Survey
Information Collection (IC) Details

View Information Collection (IC)

Field Test Survey Instrument (Web and Telephone)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Web Survey ATTACHMENT 3B WEB Field Test Survey Instrument.doc Yes Yes Fillable Printable
Other-Telephone Survey ATTACHMENT 3A Telephone Field Test Survey Instrument.doc Yes Yes Fillable Printable

Health Illness Prevention

 

1,932 0
   
Individuals or Households
 
   0 %

  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 1,932 0 1,932 0 0 0
Annual IC Time Burden (Hours) 580 0 580 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.