Information Collection

Household Survey for General Public_Study Screener

IC 208429 under ICR 201308-0920-012 · OMB 0920-0993.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0993 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Household Survey for General Public_Study Screener	Form and Instruction
Household Survey for General Public_Study Screener Attachment H_ Household Survey for General Public_ Study Screener.docx	Form and Instruction

IC Title:

Household Survey for General Public_Study Screener

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	None	Household Survey for General Public_Study Screener	Attachment H_ Household Survey for General Public_ Study Screener.docx		Yes	No	Printable Only

Line of Business: Disaster Management

Subfunction: Disaster Repair and Restore

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,252

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	5,252	5,252
Annual IC Time Burden (Hours)	175	175
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.