Information Collection

KAP Survey (Pre/Post)

IC 219606 under ICR 201601-0920-006 · OMB 0920-1110.

Documents and Forms

Document Name Document Type
KAP Survey (Pre/Post) Form and Instruction
KAP Questionnaire Att D--KAP Questionnaire_1-12-2016.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	KAP Survey (Pre/Post)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NA	KAP Questionnaire	Att D--KAP Questionnaire_1-12-2016.docx	NA	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	533	533
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.