Information Collection

PRAMS - English

IC 219197 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⚠️ Notice: This information collection may be referencing outdated material.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 - English	Form
PRAMS Phase 8 Supplemental Questions PRAMS P8 App1a 120415.docx	Form
PRAMS screener PRAMS P8 App3 Telephone Screener rev.docx	Form
0920-0222 10-day letter PRAMS English 120415.docx 10 day Letter to Dr. Schwab	IC Document
PRAMS P8 App1b 120415.docx Questions and Rationale for Selection	IC Document
PRAMS P8 App2 ad&flyers.docx Flyers and Advertisements	IC Document
PRAMS P8 App4 Informed Consent.docx Consent	IC Document

IC Title:

PRAMS - English

Agency IC Tracking Number:

16GL

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	PRAMS Phase 8 Supplemental Questions	PRAMS P8 App1a 120415.docx		Yes	No	Fillable Fileable
Form	none	PRAMS screener	PRAMS P8 App3 Telephone Screener rev.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Health and Demographic Surveys Conducted in Probability Samples o fhte 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
10 day Letter to Dr. Schwab	0920-0222 10-day letter PRAMS English 120415.docx	12/07/2015
Questions and Rationale for Selection	PRAMS P8 App1b 120415.docx	12/07/2015
Flyers and Advertisements	PRAMS P8 App2 ad&flyers.docx	12/07/2015
Consent	PRAMS P8 App4 Informed Consent.docx	12/07/2015

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