OMB
.report
Search
Time / Activity Form - for Children
The Green Housing Study
OMB: 0920-0906
IC ID: 198575
OMB.report
HHS/CDC
OMB 0920-0906
ICR 201112-0920-013
IC 198575
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0906 can be found here:
2014-09-04 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Time / Activity Form - for Children
Form
Time / Activity - Children
Appendix D10 - Time Activity (Children 7-12 yrs) 5-5-11.doc
Form
Appendix D10 - Time Activity (Children 7-12 yrs) 5-5-11_CHN7.14.2011.doc
Time/Activity - children - Chinese
IC Document
Appendix D10 - Time Activity (Children 7-12 yrs) 5-5-11 SPANISH.docx
Time/Activity - children - Spanish
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Time / Activity Form - for Children
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
none
Time / Activity - Children
Appendix D10 - Time Activity (Children 7-12 yrs) 5-5-11.doc
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
Epidemiological Studies and Surveillance of Disease Problems 09-20-0136
FR Citation:
57 FR 62812
Number of Respondents:
832
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
3,328
0
0
0
0
3,328
Annual IC Time Burden (Hours)
277
0
0
0
0
277
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Time/Activity - children - Chinese
Appendix D10 - Time Activity (Children 7-12 yrs) 5-5-11_CHN7.14.2011.doc
12/14/2011
Time/Activity - children - Spanish
Appendix D10 - Time Activity (Children 7-12 yrs) 5-5-11 SPANISH.docx
12/14/2011
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.