OMB
.report
Search
Testing Long Term Care Questions
NCHS Questionnaire Design Research Laboratory
OMB: 0920-0222
IC ID: 199221
OMB.report
HHS/CDC
OMB 0920-0222
ICR 201002-0920-006
IC 199221
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:
2022-12-21 - Revision of a currently approved collection
2021-08-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
QDRL LTC Attach 1-v2.docx
Other-Interview
QDRL LTC 10-day letter-final 2mary.doc
Letter to Margo Schwab
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Testing Long Term Care Questions
Agency IC Tracking Number:
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-Interview
QDRL LTC Attach 1-v2.docx
Yes
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population
FR Citation:
49 FR 37693
Number of Respondents:
15
Number of Respondents for Small Entity:
5
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
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
15
0
0
0
0
0
Annual IC Time Burden (Hours)
15
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Letter to Margo Schwab
QDRL LTC 10-day letter-final 2mary.doc
09/13/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.