OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Study

IC 221072 under ICR 201604-0910-007 · OMB 0910-0820.

Documents and Forms
Document Name
Document Type
Other-Survey
Other-Survey
Other-Screenshot
Other-Screenshots
Information Collection (IC) Details

View Information Collection (IC)

Study
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screenshots Study Questionnaire Screenshots Spanish-062316.docx Yes Yes Paper Only
Other-Survey Appendix D - Study Questionnaire English-062316.docx Yes Yes Fillable Fileable
Other-Screenshot Study Questionnaire Screenshots English-062316.docx Yes Yes Paper Only
Other-Survey Study Questionnaire Spanish-062316.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

3,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,000 0 3,000 0 0 0
Annual IC Time Burden (Hours) 750 0 750 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.