Information Collection

Qdrl - 2013 Nhis

IC 201536 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⚠️ Notice: This information collection may be referencing outdated material.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
QDRL - 2013 NHIS	Form
NHIS 2013 questions QDRL 10-day letter NHIS 2013 Qs - Att 1.docx	Form
QDRL OMB 10-day letter NHIS 2013 .doc Letter to Dr. Schwab	IC Document
QDRL 10-day letter NHIS 2013 Qs -Attach 2.docx Att 2 - Advertisement	IC Document

IC Title:

QDRL - 2013 NHIS

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	none	NHIS 2013 questions	QDRL 10-day letter NHIS 2013 Qs - Att 1.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

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	25	0	0	0	0	0
Annual IC Time Burden (Hours)	25	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
Letter to Dr. Schwab	QDRL OMB 10-day letter NHIS 2013 .doc	03/13/2012
Att 2 - Advertisement	QDRL 10-day letter NHIS 2013 Qs -Attach 2.docx	03/13/2012

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