English Language Folic Acid Educational Materials: Message Testing and Materials Development

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0919 can be found here:

Documents and Forms

Document Name Document Type
English Language Folic Acid Educational Materials: Message Testing and Materials Development Form
Attachment 2 Moderators Guide.docx Instruction
Consent Attachmnt 3 Consent Form.doc Form
Screener Attachment 1 Screener.doc Form
Blue_Before_Ad_Eng.pdf Before ad IC Document
CS124503_Ready_Brochure.pdf Ready brochure IC Document
124502_BlueBYKI_English_bro.pdf Before ad IC Document
09_124501_Before_Brochure_English.pdf Before brochure IC Document
GenIC Clearance SubmissionMarch27.docx GenIC application IC Document

Information Collection (IC) Details

IC Title:	English Language Folic Acid Educational Materials: Message Testing and Materials Development	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Consent	Attachmnt 3 Consent Form.doc	No	No	Paper Only
Form	none	Screener	Attachment 1 Screener.doc	No	No	Paper Only
Instruction			Attachment 2 Moderators Guide.docx	No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 480	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	480	0	0	0	0	0
Annual IC Time Burden (Hours)	160	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Before ad	Blue_Before_Ad_Eng.pdf	04/25/2012
Ready brochure	CS124503_Ready_Brochure.pdf	04/25/2012
Before ad	124502_BlueBYKI_English_bro.pdf	04/25/2012
Before brochure	09_124501_Before_Brochure_English.pdf	04/25/2012
GenIC application	GenIC Clearance SubmissionMarch27.docx	04/30/2012

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