Information Collection

Pre-test CATI Screener/CATI Recruitment

IC 206644 under ICR 201304-0920-013 · OMB 0920-0972.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Pre-test CATI Screener/CATI Recruitment	Form
Pre-test Screener Appendix C1. Screener - CATI Recruitment.docx	Form
CATI Survey Appendix D. Initial CATI Survey.docx	Form

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	none	Pre-test Screener	Appendix C1. Screener - CATI Recruitment.docx		Yes	Yes	Fillable Fileable
Form	none	CATI Survey	Appendix D. Initial CATI Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 20

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.