OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Number to Complete the Survey (85%) - Study 2

IC 220730 under ICR 201804-0910-011 · OMB 0910-0821.

Documents and Forms
Document Name
Document Type
Other-Consent Form
Other-Screener
Other-Survey
Information Collection (IC) Details

View Information Collection (IC)

Number to Complete the Survey (85%) - Study 2
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Appendix C - STUDY 2 QUESTIONNAIRE.doc Yes Yes Fillable Fileable
Other-Consent Form Appendix A - CONSENT FORM.doc Yes Yes Fillable Fileable
Other-Screener Appendix D - SCREENER.doc Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

900 0
   
Individuals or Households
 
   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 900 0 0 0 0 900
Annual IC Time Burden (Hours) 297 0 0 0 0 297
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.