Information Collection

First Web Survey Follow-up for Smartphone Users

IC 206647 under ICR 201304-0920-013 · OMB 0920-0972.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
First Web Survey Follow-up for Smartphone Users	Form
Smartphone Web Survey Follow-up Appendix E. First Web Survey Follow-up Smartphone Users_4 08 2013.docx	Form
Appendix E2. Invitation for First Web Survey Follow-up for Smartphone Users.docx Invitation for First Web Survey	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	none	Smartphone Web Survey Follow-up	Appendix E. First Web Survey Follow-up Smartphone Users_4 08 2013.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 700

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	700	700
Annual IC Time Burden (Hours)	35	35
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Invitation for First Web Survey	Appendix E2. Invitation for First Web Survey Follow-up for Smartphone Users.docx	04/17/2013

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