Information Collection

Sample Frame Test-line 10

IC 205038 under ICR 201212-0920-003 · OMB 0920-0214.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0214 can be found here:

Documents and Forms

Document Name Document Type
Sample Frame Test-line 10 Form
Methodological sample frame test of 5,000 persons CATI-CAPI Questionnaire (2) Att6.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Sample Frame Test-line 10	Agency IC Tracking Number:

Is this a Common Form? No		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	none	Methodological sample frame test of 5,000 persons	CATI-CAPI Questionnaire (2) Att6.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: Health and Demographuc==ic Surveys Conducted in Probability Samples of the US Populations	FR Citation: 49 FR 37693

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	2,500	2,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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