Information Collection

National Survey of Children's Health Pretest

IC 216350 under ICR 201504-0607-011 · OMB 0607-0984.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A -NSCH 2015 Pretest - Respondent Contact Materials 042815.pdf	Instruction
Appendix B -NSCH 2015 Pretest - Questionnaires.pdf	Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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
Instruction			Appendix A -NSCH 2015 Pretest - Respondent Contact Materials 042815.pdf		Yes	Yes	Fillable Fileable
Instruction			Appendix B -NSCH 2015 Pretest - Questionnaires.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 16,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 40 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	16,000	16,000
Annual IC Time Burden (Hours)	2,262	2,262
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.