Information Collection

Research and Development Survey (RANDS) Cognitive Interviewing Sub-Study

IC 229901 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⚠️ Notice: This information collection may be referencing outdated material.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
Attach 2 - Questionnaire 012418.docx	Other-WORD
Attach 4 - Telephone Screener.docx	Other-WORD
Attach 3 - Advertisement.docx Att 3_Recruitment Advertisement	IC Document
Attach 5 - Informed Consent.docx Att 5_ Adult Informed Consent	IC Document
Attach 6 - Resp Data Collect.docx Att 6 Respondent Data Collection Sheet	IC Document
Attach 7 - Thank You Letter.docx Att 7_Thank You Letter	IC Document
Attach 8 - Special Consent.docx Att 8_Special Consent	IC Document
Attach 9 - Analysis Plan.docx Att 9_Analysis Plan	IC Document
Rands 10-day Letter 012418.docx RANDS 10-Day Letter	IC Document

IC Title:

Research and Development Survey (RANDS) Cognitive Interviewing Sub-Study

Agency IC Tracking Number:

0920-0222 18ML

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
Other-WORD			Attach 2 - Questionnaire 012418.docx		No		Paper Only
Other-WORD			Attach 4 - Telephone Screener.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population

FR Citation: 49 FR 37693

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	90	90
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 3_Recruitment Advertisement	Attach 3 - Advertisement.docx	01/30/2018
Att 5_ Adult Informed Consent	Attach 5 - Informed Consent.docx	01/30/2018
Att 6 Respondent Data Collection Sheet	Attach 6 - Resp Data Collect.docx	01/30/2018
Att 7_Thank You Letter	Attach 7 - Thank You Letter.docx	01/30/2018
Att 8_Special Consent	Attach 8 - Special Consent.docx	01/30/2018
Att 9_Analysis Plan	Attach 9 - Analysis Plan.docx	01/30/2018
RANDS 10-Day Letter	Rands 10-day Letter 012418.docx	01/30/2018

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