OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

General population – outcome screener (in person)

IC 218387 under ICR 201810-0910-015 · OMB 0910-0808.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Attachment 08 Script for Recruiting Intercept Participants_FU6.docx Other-Script for Recruiting Intercep
Attachment 05 CrossSectional Screener Inf Con_FU6.docx Other-Screener Informed Consent
Attachment 03 New Participant Screener_FU6.docx Other-Screener
Attachment 02b Video Storyboards FU6.docx Other-Video Storyboards

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-Script for Recruiting Intercept Participants Attachment 08 Script for Recruiting Intercept Participants_FU6.docx No   Printable Only
Other-Screener Informed Consent Attachment 05 CrossSectional Screener Inf Con_FU6.docx Yes Yes Fillable Fileable
Other-Screener Attachment 03 New Participant Screener_FU6.docx Yes Yes Fillable Fileable
Other-Video Storyboards Attachment 02b Video Storyboards FU6.docx Yes No Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  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 11,239 0 0 1,984 0 9,255
Annual IC Time Burden (Hours) 933 0 0 165 0 768
Annual IC Cost Burden (Dollars) 0 0 0 0 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.