Information Collection

Survey on Sodium Awareness

IC 194197 under ICR 201008-0920-003 · OMB 0920-0864.

Documents and Forms

Documents and forms in this information collection
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

IC Title:

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
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 %

table that charts list of burden
	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

table that charts IC Documents
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.