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Federal forms, ICRs, and supporting documents

Information Collection

Eligible Household (Completes Survey)

IC 192631 under ICR 201208-0955-012 · OMB 0955-0012.

Documents and Forms
Document Name
Document Type
Other-questionaire
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Eligible Household (Completes Survey)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-questionaire AttachmentD_Questionnaire_FinalRev_070110_FINAL.doc No   Paper Only

Health Public Health Monitoring

 

2,570 0
   
Individuals or Households
 
   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 2,570 0 2,570 0 0 0
Annual IC Time Burden (Hours) 857 0 857 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
0990-attitudestowardelectronic attachment_A_Sample Search Terms 0990-attitudestowardelectronic attachment_A_Sample Search Terms.doc 03/22/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.