Baseline Questionnaire - Home Characteristics

The Green Housing Study

OMB: 0920-0906

IC ID: 198567

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Form
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Baseline Questionnaire - Home Characteristics
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form N/A REVISED_APPENDIX_D1_Baseline (Home Characteristics)_October 20.2011 REVISED_APPENDIX_D1_Baseline (Home Characteristics)_October 20.2011.doc Yes No Paper Only

Health Immunization Management

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

832 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 832 0 0 0 0 832
Annual IC Time Burden (Hours) 208 0 0 0 0 208
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Baseline - home characteristics - Chinese Baseline (Home Characteristics) Chinese version - November 30, 2011.doc 12/14/2011
Baseline - home characteristics - Spanish Baseline (Home Characteristics) SPANISH - November 30, 2011.doc 12/14/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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