Information Collection

Flexible Consumer Behavior Survey Phone Follow-up

IC 218879 under ICR 201611-0920-002 · OMB 0920-0950.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0950 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0950 Flexible Consumer Behavior Survey Phone Follow-up Form
Att_13a_FCBS 17-18 101816.docx Instruction
0920-0950 Flexible Consumer Behavior Survey (FCBS) Att_13b_FCBS 17-18 101316.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Flexible Consumer Behavior Survey Phone Follow-up	Agency IC Tracking Number:	0920-0950

Is this a Common Form? No		IC Status: Modified

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	0920-0950	Flexible Consumer Behavior Survey (FCBS)	Att_13b_FCBS 17-18 101316.docx		Yes	Yes	Fillable Fileable
Instruction			Att_13a_FCBS 17-18 101816.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0167 Health Resources Utilization Statistics	FR Citation: 49 FR 37693

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,000	4,725	275
Annual IC Time Burden (Hours)	1,667	1,667	0
Annual IC Cost Burden (Dollars)	0	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.