Information Collection

NHANES Pilot Studies 2012

IC 202148 under ICR 201010-0920-007 · OMB 0920-0237.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0237 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NHANES 2012 Pilot HPV Men Attachment A.DOC	Instruction
NHANES 2012_Pilot Oral Health Fluorosis Attachment B.DOC	Instruction
NHANES 2012 pilot-special studies and remun. combo letter final 050112.doc Letter to Dr. Schwab	IC Document
NHANES 2012 Pilot sup st_v1 combined pilots resubmitted 050112.doc Supporting Statement	IC Document

IC Title:

NHANES Pilot Studies 2012

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
Instruction			NHANES 2012_Pilot Oral Health Fluorosis Attachment B.DOC		No	No	Paper Only
Instruction			NHANES 2012 Pilot HPV Men Attachment A.DOC		No	No	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title: Health and Demographic Surveys Conducted in Probability Samples of the US

FR Citation: 49 FR 37693

Number of Respondents: 355

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

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	355	0	0	0	0	0
Annual IC Time Burden (Hours)	46	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	NHANES 2012 pilot-special studies and remun. combo letter final 050112.doc	05/02/2012
Supporting Statement	NHANES 2012 Pilot sup st_v1 combined pilots resubmitted 050112.doc	05/02/2012

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