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Automated Self-Administered 24-hour Recall (ASA24) for FORCS
Food Reporting Comparison Study (FORCS) and Food and Eating Assessment Study (FEAST) (NCI)
OMB: 0925-0605
IC ID: 190234
OMB.report
HHS/NIH
OMB 0925-0605
ICR 201107-0925-003
IC 190234
( )
Documents and Forms
Document Name
Document Type
Form 4
Automated Self-Administered 24-hour Recall (ASA24) for FORCS
Form and Instruction
4 Automated Self-Administered 24-hour Recall (ASA24)
Attach 2 - ASA24 Screenshots 11-0330.docx
asa24.westat.com/
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Automated Self-Administered 24-hour Recall (ASA24) for FORCS
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Form and Instruction
4
Automated Self-Administered 24-hour Recall (ASA24)
Attach 2 - ASA24 Screenshots 11-0330.docx
http://asa24.westat.com/
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
09-25-0156, "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"
FR Citation:
67 FR 60743
Number of Respondents:
400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
400
0
0
-86
0
486
Annual IC Time Burden (Hours)
200
0
0
-43
0
243
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.