Burden Estimates Spreadsheet

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Generic Clearance to Conduct Formative Research/CNPP

Burden Estimates Spreadsheet

OMB: 0584-0523

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Respondents Non-Respondents
Affected Public Respondents Type Instrument
SAMPLE SIZE Number of respondents Frequency of data collection Total responses Time per response (hours) Total Estimated annual burden (hours) Number of non-respondents Frequency of data collection Total responses Time per response Total burden estimate Grand Total burden estimate
Attachment
Individual/ Households Subtotal Individuals and Households
Individuals and Households Inviation












English Language respondents A1 1183 947 1 947 0.03 28.41 236 1 236 0.03 7.08 35.49
Spanish Language respondents A2 394 315 1 315 0.03 9.45 79 1 79 0.03 2.37 11.82
Consent





0.00





English Language Consent D1 947 947 1 947 0.03 28.41 0 1 0 0 0 28.41
Spanish Langage Consent D2 315 315 1 315 0.03 9.45 0 1 0 0 0 9.45
Screener












Screener(English) B1 947 900 1 947 0.08 75.76 0 1


75.76
Screener (Spanish) B2 315 300 1 315 0.1 31.50 0 1


31.5
Survey












Survey (English) C1 900 900 1 900 0.25 225.00 47 1 47 0 0 225
Survey (Spanish) C2 300 300 1 300 0.25 75.00 15 1 15 0 0 75
Individual/ Households Subtotal 1,577 1,200 - 4,986 - 482.98 377 - 377 - 9.45 492.43
















































Instrument Total Number of Participants Number of respondents Proportion of Responders Number of non-respondents Proportion of non-respondents



















Invitation














Invitation for English Language Survey 1183 947 80% 236 20%









Invitation for Spanish Language Survey 394 315 80% 79 20% 









Screener














Invitation for English Language Survey 947 947 100% 0 0%









Invitation for Spanish Language Survey 315 315 100% 0 0%









Survey














English Language Survey 947 900 95% 47 5%









Spanish Language Survey 300 300 95% 15 5%










1577 1200
377










































































































































































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