Information Collection

Digital Media Testing and Copy Testing for Terrie Hall Rough Cuts

IC 209421 under ICR 201109-0920-009 · OMB 0920-0910.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0910 can be found here:

Documents and Forms

Document Name Document Type
Digital Media Testing and Copy Testing for Terrie Hall Rough Cuts Form and Instruction
Digital Media Testing for Rough Cuts Screener Att 1a. SCREENER 11082013 v5.0 (Screen Shots).pdf Form and Instruction
Digital Media Testing and Copy Testing for Terrie Hall R Att 1b. MAIN 11082013 v5.0 (Screen Shots).pdf Form and Instruction
Att 1a. Screener - Terrie Hall Rough Cut Tests_111513.docx Att 1a IC Document
Att 1b. Main Quex - Terrie Hall Rough Cut Tests.docx Att 1b IC Document
Att 2. Email Recruit Terrie Hall Rough Cut Tests.docx Att 2 IC Document
Att 3. Privacy Policy Terrie Hall Rough Cut Tests.docx Att 3 IC Document
Att 4. Terms and Conditions Terrie Hall Rough Cut Tests.docx Att 4 IC Document
Att 5. Statement by CDC Director.pdf Att 5 IC Document
0920-0910_IC_Part B_Terrie Hall Rough Cut Tests_112013.doc.docx 0920-0910_IC_Part B_Terrie Hall Rough Cut Tests_112013 IC Document
0920-0910_IC_Part A_Terrie Hall Rough Cut Tests_112013.doc.docx 0920-0910_IC_Part A_Terrie Hall Rough Cut Tests_112013 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Digital Media Testing and Copy Testing for Terrie Hall Rough Cuts	Agency IC Tracking Number:

IC Status: New

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	None	Digital Media Testing for Rough Cuts Screener	Att 1a. SCREENER 11082013 v5.0 (Screen Shots).pdf		Yes	Yes	Fillable Fileable
Form and Instruction	None	Digital Media Testing and Copy Testing for Terrie Hall Rough Cuts--Main Questionnaire	Att 1b. MAIN 11082013 v5.0 (Screen Shots).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,025	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	4,025	0	0	0	0	0
Annual IC Time Burden (Hours)	1,060	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Att 1a	Att 1a. Screener - Terrie Hall Rough Cut Tests_111513.docx	11/15/2013
Att 1b	Att 1b. Main Quex - Terrie Hall Rough Cut Tests.docx	11/15/2013
Att 2	Att 2. Email Recruit Terrie Hall Rough Cut Tests.docx	11/15/2013
Att 3	Att 3. Privacy Policy Terrie Hall Rough Cut Tests.docx	11/15/2013
Att 4	Att 4. Terms and Conditions Terrie Hall Rough Cut Tests.docx	11/15/2013
Att 5	Att 5. Statement by CDC Director.pdf	11/15/2013
0920-0910_IC_Part B_Terrie Hall Rough Cut Tests_112013	0920-0910_IC_Part B_Terrie Hall Rough Cut Tests_112013.doc.docx	11/20/2013
0920-0910_IC_Part A_Terrie Hall Rough Cut Tests_112013	0920-0910_IC_Part A_Terrie Hall Rough Cut Tests_112013.doc.docx	11/20/2013

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