Children's and Aging Forums Data User Surveys

Customer Surveys Generic Clearance for the National Center for Health Statistics

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0729 can be found here:

Documents and Forms

Document Name Document Type
Children's and Aging Forums Data User Surveys Form and Instruction
Children’s Forum Data User Survey Questions Att A Children’s Forum Data User Survey Questions.docx Form and Instruction
Aging Forum Data User Questions Att B Aging Forum Data User Survey Questions Revised.docx Form and Instruction
Supporting Statement A_050516.doc Supporting Statement A IC Document
Supporting Statement B 050516.docx Supporting Statement B IC Document

Information Collection (IC) Details

IC Title:	Children's and Aging Forums Data User Surveys	Agency IC Tracking Number:	16AJB

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
Form and Instruction	NA	Children’s Forum Data User Survey Questions	Att A Children’s Forum Data User Survey Questions.docx	NA	Yes	Yes	Fillable Fileable
Form and Instruction	NA	Aging Forum Data User Questions	Att B Aging Forum Data User Survey Questions Revised.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	267	267
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	Supporting Statement A_050516.doc	05/09/2016
Supporting Statement B	Supporting Statement B 050516.docx	05/09/2016

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