Information Collection

Nhanes

IC 201298 under ICR 201202-0920-006 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att 5c_2003 Birth Certificate.pdf	Other-WORD
Att 5b_1989 Birth Certificate.pdf	Other-WORD
Att 5d_BC Pregnant Women obtaining certificate.docx Att 5d_BC Pregnant Women obtaining certificate	IC Document

IC Title:

NHANES

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD			Att 5c_2003 Birth Certificate.pdf		No	No	Fillable Printable
Other-WORD			Att 5b_1989 Birth Certificate.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the US Population

FR Citation: 49 FR 37693

Number of Respondents: 57

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	741	741
Annual IC Time Burden (Hours)	62	62
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 5d_BC Pregnant Women obtaining certificate	Att 5d_BC Pregnant Women obtaining certificate.docx	02/10/2012

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