Information Collection

Pre-testing of the Spanish HSOII

IC 228571 under ICR 201706-1220-008 · OMB 1220-0141.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment 1 & 2 Pre-testing of the Spanish HSOII	Form
Attachment 1 & 2 Survey Protocol Attachment 1 & 2 - HSOII Spanish Survey Protocol.docx	Form
Note to Review - HSOII Spanish Cognitive Testing.doc Note to Reviewer - Pre-testing of the Spanish HSOII	IC Document

IC Title:

Pre-testing of the Spanish HSOII

Agency IC Tracking Number:

21801

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
Form	Attachment 1 & 2	Survey Protocol	Attachment 1 & 2 - HSOII Spanish Survey Protocol.docx		Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 80

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	120	120
Annual IC Time Burden (Hours)	47	47
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to Reviewer - Pre-testing of the Spanish HSOII	Note to Review - HSOII Spanish Cognitive Testing.doc	10/05/2017

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