Information Collection

Conducting Testing on NHIS and NHANES Questions

IC 193241 under ICR 201002-0920-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form No number Conducting Testing on NHIS and NHANES Questions	Form
No number Testing NHIS and NHANES Questions Attachment 2-v3.docx	Form
Attachment 1.doc Recruitment Flyer	IC Document
QDRL OMB-10-day letter-NHIS Wellness & NHANES-v2.doc 10-Day Letter to Margo Schwab	IC Document

IC Title:

Conducting Testing on NHIS and NHANES Questions

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
Form	No number	Testing NHIS and NHANES Questions	Attachment 2-v3.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the United States Population

FR Citation: 49 FR 37693

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	30	0	0	0	0	0
Annual IC Time Burden (Hours)	30	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
Recruitment Flyer	Attachment 1.doc	06/08/2010
10-Day Letter to Margo Schwab	QDRL OMB-10-day letter-NHIS Wellness & NHANES-v2.doc	06/08/2010

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