Information Collection

Tuberculosis Education Materials for Classified Immigrants

IC 231138 under ICR 201711-0920-019 · OMB 0920-1071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-1071 Tuberculosis Education Materials for Classified Immigrants	Form and Instruction
0920-1071 Att C_B1 Key Informant Interview Guide Att C - B1 Key Informant Interview Guide MX.DOCX	Form and Instruction
0920-1071 Att D_B2 Key Information Interview Guide--MX Att D - B2 Key Informant Interview Guide MX.DOCX	Form and Instruction
0920-1071 Att E_B1 Key Information Interview Guide -- US Att E - B1 Key Informant Interview Guide US.DOCX	Form and Instruction
0920-1071 Att F_B2 Key Informant Interview Guide -- US Att F - B2 Key Informant Interview Guide US.DOCX	Form and Instruction
Request Approval_TB Education Materials.docx Request for APPROVAL	IC Document
Att A - B1 Sample Education Materials.docx Att A: B1 Sample Education Materials	IC Document
Att B - B2 Sample Education Materials.docx Att B: B2 Sample Education Materials	IC Document
Att G - Approach Script.docx Att G_B1B2 Approach Script	IC Document
Att H - Non-research determination.pdf Att H_Non Research Determination	IC Document

IC Title:

Tuberculosis Education Materials for Classified Immigrants

Agency IC Tracking Number:

0920-1071 (18ABU)

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	Available Electronically?	Electronic Capability
Form and Instruction	0920-1071	Att C_B1 Key Informant Interview Guide	Att C - B1 Key Informant Interview Guide MX.DOCX	No	Paper Only
Form and Instruction	0920-1071	Att D_B2 Key Information Interview Guide--MX	Att D - B2 Key Informant Interview Guide MX.DOCX	No	Paper Only
Form and Instruction	0920-1071	Att E_B1 Key Information Interview Guide -- US	Att E - B1 Key Informant Interview Guide US.DOCX	No	Paper Only
Form and Instruction	0920-1071	Att F_B2 Key Informant Interview Guide -- US	Att F - B2 Key Informant Interview Guide US.DOCX	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 70

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	70	70
Annual IC Time Burden (Hours)	129	129
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for APPROVAL	Request Approval_TB Education Materials.docx	04/25/2018
Att A: B1 Sample Education Materials	Att A - B1 Sample Education Materials.docx	04/25/2018
Att B: B2 Sample Education Materials	Att B - B2 Sample Education Materials.docx	04/25/2018
Att G_B1B2 Approach Script	Att G - Approach Script.docx	04/25/2018
Att H_Non Research Determination	Att H - Non-research determination.pdf	04/25/2018

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