Information Collection

National Survey of Children's Health Pretest

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

Documents and Forms

Document Name Document Type
Appendix A -NSCH 2015 Pretest - Respondent Contact Materials 042815.pdf Instruction
Appendix B -NSCH 2015 Pretest - Questionnaires.pdf Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Survey of Children's Health Pretest	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection 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 %

	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

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.