Information Collection

PRAMS Phase 8 - Spanish

IC 218569 under ICR 201506-0920-003 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PRAMS Phase 8 - Spanish	Form
PRAMS Phase 8 - Spanish Appendix 1 Qnne Spanish PRAMS final rev 101415.docx	Form
Screener Appendix 3 rev Tele Screener Span PRAMS 101415.docx	Form and Instruction
Respondent Data Sheet Appendix 5 Resp Data Collection Sheet Spanish PRAMS.docx	Form
0920-0222 10-day PRAMS Spanish final rev 101415.docx Letter to Dr. Schwab	IC Document
Appendix 2a-d Ad&Flyer Spanish PRAMS.docx Advertisement/Flyer	IC Document
Appendix 4 Informed Consent Spanish PRAMS.docx Consent	IC Document
Appendix 6 Thank You letter Spanish PRAMS.docx Thank you Letter	IC Document

IC Title:

PRAMS Phase 8 - Spanish

Agency IC Tracking Number:

16BF

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	PRAMS Phase 8 - Spanish	Appendix 1 Qnne Spanish PRAMS final rev 101415.docx	Yes	Yes	Fillable Fileable
Form and Instruction	none	Screener	Appendix 3 rev Tele Screener Span PRAMS 101415.docx	Yes	Yes	Fillable Fileable
Form	none	Respondent Data Sheet	Appendix 5 Resp Data Collection Sheet Spanish PRAMS.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Health adn Demogrpahic Surveys Conducted in Probability Samples of the US Population

FR Citation: 49 FR 37693

Number of Respondents: 68

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	68	68
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Letter to Dr. Schwab	0920-0222 10-day PRAMS Spanish final rev 101415.docx	10/14/2015
Advertisement/Flyer	Appendix 2a-d Ad&Flyer Spanish PRAMS.docx	10/14/2015
Consent	Appendix 4 Informed Consent Spanish PRAMS.docx	10/14/2015
Thank you Letter	Appendix 6 Thank You letter Spanish PRAMS.docx	10/14/2015

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