Information Collection

Households (adults 18 and up); Mail screener

IC 228778 under ICR 201810-0910-002 · OMB 0910-0851.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0851 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment_1a_Mail_screener.docx	Other-Mail Screener

IC Title:

Households (adults 18 and up); Mail screener

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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
Other-Mail Screener			Attachment_1a_Mail_screener.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9,217

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	Previously Approved
Annual Number of Responses for this IC	9,217	9,217
Annual IC Time Burden (Hours)	1,567	1,567
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.