NCHS Research and Development Survey (RANDS)

Collaborating Center for Questionnaire Design and Evaluation Research

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

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

Information Collection (IC) Details

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:

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 %

	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

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.