Information Collection

Att. H_Screener Script Guide

IC 221945 under ICR 201606-0920-004 · OMB 0920-1145.

Documents and Forms

Document Name Document Type
Att. H_Screener Script Guide_051916.DOCX Other-WORD

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Att. H_Screener Script Guide	Agency IC Tracking Number:	16CA

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
Other-WORD			Att. H_Screener Script Guide_051916.DOCX		No		Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0160 "Records of Subjects in Health Promotion and Education Studies"	FR Citation: 51 FR 42484

Number of Respondents: 667	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	667	667
Annual IC Time Burden (Hours)	111	111
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.