Survey on Sodium Awareness

Improving the Quality and Delivery of CDC's Heart Disease and Stroke Prevention Programs

Documents and Forms

Document Name Document Type
Att_5b_IC_2-Sodium_tooklit_survey050710.docx Other-Web Survey
Att_5a_IC_2-Overview050710.docx Overview Document IC Document
Att_5c_IC_2-Advance_Notice_Email0507010.docx EMail Notice IC Document
Att_5d_IC_2-Follow-Up_Email050710.docx Follow-up EMail Notice IC Document

Information Collection (IC) Details

IC Title:	Survey on Sodium Awareness	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-Web Survey			Att_5b_IC_2-Sodium_tooklit_survey050710.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 269	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	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	269	0	0	0	0	0
Annual IC Time Burden (Hours)	90	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Overview Document	Att_5a_IC_2-Overview050710.docx	07/12/2010
EMail Notice	Att_5c_IC_2-Advance_Notice_Email0507010.docx	07/12/2010
Follow-up EMail Notice	Att_5d_IC_2-Follow-Up_Email050710.docx	07/12/2010

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