Information Collection

24HR Recall Comparison Study Screenshots of Information and Consent

IC 190231 under ICR 201107-0925-003 · OMB 0925-0605.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 24HR Recall Comparison Study Screenshots of Information and Consent	Form and Instruction
1 Comparison Study Screenshot Information and Consent Attach2 - 24HR comparison screenshots information and consent.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form?

IC Status: Removed

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
Form and Instruction	1	Comparison Study Screenshot Information and Consent	Attach2 - 24HR comparison screenshots information and consent.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 650

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-650	650
Annual IC Time Burden (Hours)	-163	163
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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