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NSFG Screener Verification
National Survey of Family Growth
OMB: 0920-0314
IC ID: 216268
OMB.report
HHS/CDC
OMB 0920-0314
ICR 201707-0920-011
IC 216268
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0314 can be found here:
2024-04-03 - No material or nonsubstantive change to a currently approved collection
2023-08-28 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
NSFG Screener Verification
Form and Instruction
NSFG Verification Questionnaire - Screener
ATT K1 Screener Verification Quex022015.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NSFG Screener Verification
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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 and Instruction
None
NSFG Verification Questionnaire - Screener
ATT K1 Screener Verification Quex022015.doc
None
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population
FR Citation:
49 FR 37693
Number of Respondents:
1,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
1,500
0
0
0
0
1,500
Annual IC Time Burden (Hours)
50
0
0
0
0
50
Annual IC Cost Burden (Dollars)
0
0
0
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.