Information Collection

Physical Activity Subsample Study

IC 210034 under ICR 201401-0925-004 · OMB 0925-0593.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0593 can be found here:

Documents and Forms

Document Name Document Type
Form 42.1 Physical Activity Subsample Study Form and Instruction
PhysicalActivityGPSMonitorShippingInstructions.docx Instruction
42.1 Survey PhysicalActivityMonitorSAQ.docx Form and Instruction
42.2 Survey PhysicalActivityMonitorPickUpInstrument.docx Form and Instruction
42.3 Survey PhysicalActivityMonitorLogSAQ.docx Form and Instruction
42.4 Survey PhysicalActivityMonitorSetUpInstrument.docx Form and Instruction
PhysicalActivityMonitorGPSInstructions.docx PhysicalActivityMonitorGPSInstructions IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Physical Activity Subsample Study	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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	42.1	Survey	PhysicalActivityMonitorSAQ.docx	Yes	Yes	Paper Only
Form and Instruction	42.2	Survey	PhysicalActivityMonitorPickUpInstrument.docx	Yes	Yes	Paper Only
Form and Instruction	42.3	Survey	PhysicalActivityMonitorLogSAQ.docx	Yes	Yes	Paper Only
Form and Instruction	42.4	Survey	PhysicalActivityMonitorSetUpInstrument.docx	Yes	Yes	Paper Only
Instruction			PhysicalActivityGPSMonitorShippingInstructions.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: 200	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	600	600
Annual IC Time Burden (Hours)	430	430
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
PhysicalActivityMonitorGPSInstructions	PhysicalActivityMonitorGPSInstructions.docx	11/07/2013

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