Information Collection

Cognitive Interview Guide

IC 206117 under ICR 201303-0925-002 · OMB 0925-0673.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2.1 Cognitive Interview Guide	Form and Instruction
2.1 Survey Attach 6. Cognitive Interview Guide.docx	Form and Instruction
Attach 4. Newest Vital Sign Food Label.pdf Attach 4. Newest Vital Sign Food Label	IC Document
Attach 10. Note to File.docx Attach 10. Note to File	IC Document

IC Title:

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
Form and Instruction	2.1	Survey	Attach 6. Cognitive Interview Guide.docx		Yes	Yes	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attach 4. Newest Vital Sign Food Label	Attach 4. Newest Vital Sign Food Label.pdf	02/14/2013
Attach 10. Note to File	Attach 10. Note to File.docx	02/14/2013

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