Information Collection

In-Home Food Safety Behaviors and Consumer Education: Annual Observational Study

IC 226809 under ICR 201702-0583-002 · OMB 0583-0169.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0169 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appx E_Screening Questionnaires_6_28_17.docx	Other-screening questionnaires
Appx A_study design.docx Study Design	IC Document
Appx B_recruiting ads.docx Recruiting Ads	IC Document
Appx C_Recruiting Email.docx Recruiting Email	IC Document
Appx D_Recruiting Sign.docx Recruiting Sign	IC Document
Appx F_Recruit Call Script.docx Recruiting Call Script	IC Document
Appx G_Confirmation Email.docx Confirmation Email	IC Document
Appx H_Reminder Call Script.docx Reminder Call Script	IC Document
Appx J_Consent Form_5_10_17.docx Consent Form	IC Document
Appx L_Recipes and Instructions.docx Recipes and Instructions	IC Document

IC Title:

In-Home Food Safety Behaviors and Consumer Education: Annual Observational Study

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
Other-screening questionnaires			Appx E_Screening Questionnaires_6_28_17.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,999

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	1,999	1,999
Annual IC Time Burden (Hours)	2,942	2,942
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Study Design	Appx A_study design.docx	05/17/2017
Recruiting Ads	Appx B_recruiting ads.docx	05/17/2017
Recruiting Email	Appx C_Recruiting Email.docx	05/17/2017
Recruiting Sign	Appx D_Recruiting Sign.docx	05/17/2017
Recruiting Call Script	Appx F_Recruit Call Script.docx	05/17/2017
Confirmation Email	Appx G_Confirmation Email.docx	05/17/2017
Reminder Call Script	Appx H_Reminder Call Script.docx	05/17/2017
Consent Form	Appx J_Consent Form_5_10_17.docx	05/17/2017
Recipes and Instructions	Appx L_Recipes and Instructions.docx	05/17/2017

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.