Information Collection

Cognitive Interview Screener

IC 208377 under ICR 201308-0910-006 · OMB 0910-0763.

Documents and Forms

Document Name Document Type
Appendix A Fortification Study Cognitive Interview Screener.doc Other-Cognitive Interview Screener

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cognitive Interview Screener	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
Other-Cognitive Interview Screener			Appendix A Fortification Study Cognitive Interview Screener.doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	6	6
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.