OMB
.report
Search
Adult and Child Disability Questions
NCHS Questionnaire Design Research Laboratory
OMB: 0920-0222
IC ID: 209941
OMB.report
HHS/CDC
OMB 0920-0222
ICR 201205-0920-001
IC 209941
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:
2022-12-21 - Revision of a currently approved collection
2021-08-16 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Adult and Child Disability Questions
Form and Instruction
Screening Script
0920-0222 Attach 3 - Screening script 0106 2014.docx
Form and Instruction
Adult Disability Questions
0920-0222 Attachment 1a - Adult Disability Questions 0106 2014.doc
Form
Child Disability Questions
0920-0222 Attachment 1b - Child Disability Questions 0106 2014.docx
Form
0920-0222 QDRL Adult Child Disabilty 10-day letter 0106 2014 (nonhighlighted).docx
Letter to Dr. Schwab
IC Document
0920-0222 Attach 2a-f Advertisements & Flyers.docx
Att 2 - Advertisements
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Adult and Child Disability Questions
Agency IC Tracking Number:
IC Status:
New
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 and Instruction
none
Screening Script
0920-0222 Attach 3 - Screening script 0106 2014.docx
No
No
Fillable Printable
Form
none
Adult Disability Questions
0920-0222 Attachment 1a - Adult Disability Questions 0106 2014.doc
No
No
Fillable Printable
Form
none
Child Disability Questions
0920-0222 Attachment 1b - Child Disability Questions 0106 2014.docx
No
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
Health and Demographic Surveys Conducted in Probability Samples of the US Population
FR Citation:
49 FR 37693
Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
100
0
0
0
0
0
Annual IC Time Burden (Hours)
100
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Letter to Dr. Schwab
0920-0222 QDRL Adult Child Disabilty 10-day letter 0106 2014 (nonhighlighted).docx
01/08/2014
Att 2 - Advertisements
0920-0222 Attach 2a-f Advertisements & Flyers.docx
01/08/2014
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.