Information Collection

Household questionnaire

IC 218358 under ICR 201509-0648-012 · OMB 0648-0723.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Household questionnaire	Form
Manell-Geus Household Survey Questionnaire Manell-Geus Household Survey Questionnaire Final_Sep_22_2015.docx	Form
Manell-Geuss Household survey Manell-Geus Household Survey Questionnaire Final_clean.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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	NA	Manell-Geus Household Survey Questionnaire	Manell-Geus Household Survey Questionnaire Final_Sep_22_2015.docx		Yes	No	Paper Only
Form	NA	Manell-Geuss Household survey	Manell-Geus Household Survey Questionnaire Final_clean.docx		Yes	No	Paper Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

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	117	117
Annual IC Time Burden (Hours)	117	117
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.