Information Collection

NCHS Research and Development Survey (RANDS)

IC 233931 under ICR 201807-0920-004 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-0222 NCHS Research and Development Survey (RANDS)	Form and Instruction
0920-0222 Web Questionnaire Introduction Screen and RANDS Question Attachment 1 - Web Intro Screen Questionnaire 102418.docx	Form and Instruction
Attachment 2 - Nondisclosure affidavit.docx RANDS - NonDisclosure Agreement	IC Document
RANDS 10-day letter 102418.docx RANDS - 10 Day Letter	IC Document

IC Title:

NCHS Research and Development Survey (RANDS)

Agency IC Tracking Number:

0920-0222-19DJ

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 and Instruction	0920-0222	Web Questionnaire Introduction Screen and RANDS Questionnaire	Attachment 1 - Web Intro Screen Questionnaire 102418.docx	NA	Yes	Yes	Fillable Fileable

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: 4,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	1,333	1,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
RANDS - NonDisclosure Agreement	Attachment 2 - Nondisclosure affidavit.docx	11/07/2018
RANDS - 10 Day Letter	RANDS 10-day letter 102418.docx	11/07/2018

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