Information Collection

Cognitive Interview, Pretest, and Survey (Study 2)

IC 191570 under ICR 201005-0910-012 · OMB 0910-0655.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
symbol experiment study 1 and 2 cognitive interview screener (appendix M) 120909.doc	Other-cognitive interview screener
nutrition symbol study 2 screenshots 021210.ppt	Other-experiment 2 screenshots
symbol experiment study 2 pretest and survey invitation (Appendix F).doc symbol experiment study 2 pretest and survey invitation (Appendix F)	IC Document
symbol experiment study 2 reminder email (Appendix L).doc symbol experiment study 2 reminder email (Appendix L)	IC Document
symbol STUDY 2 appendices 021210 clean.doc symbol STUDY 2 appendices 021210 clean	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-cognitive interview screener			symbol experiment study 1 and 2 cognitive interview screener (appendix M) 120909.doc		Yes	Yes	Fillable Fileable
Other-experiment 2 screenshots			nutrition symbol study 2 screenshots 021210.ppt		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 27,344

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	Previously Approved
Annual Number of Responses for this IC	27,344	27,344
Annual IC Time Burden (Hours)	2,186	2,186
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
symbol experiment study 2 pretest and survey invitation (Appendix F)	symbol experiment study 2 pretest and survey invitation (Appendix F).doc	12/09/2009
symbol experiment study 2 reminder email (Appendix L)	symbol experiment study 2 reminder email (Appendix L).doc	12/09/2009
symbol STUDY 2 appendices 021210 clean	symbol STUDY 2 appendices 021210 clean.doc	02/12/2010

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