Screening Questionnaire

The Green Housing Study

OMB: 0920-0906

IC ID: 198566

Information Collection (IC) Details

View Information Collection (IC)

Screening Questionnaire
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screening Questionnaire Appendix D12 - Screening questionnaire 7-5-11.doc Yes No Paper Only

Health Immunization Management

Epidemiologic Studies and Surveillance of Disease Problems 09-20-0136  57 FR 62812

1,000 0
   
Individuals or Households
 
   0 %

  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 1,000 0 1,000 0 0 0
Annual IC Time Burden (Hours) 167 0 167 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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