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FoodNet Survey
FoodNet Population Survey
OMB: 0920-1112
IC ID: 217980
OMB.report
HHS/CDC
OMB 0920-1112
ICR 201812-0920-001
IC 217980
( )
Documents and Forms
Document Name
Document Type
FoodNet Survey
Form
FoodNet Population Survey
Attachment C. FoodNet Population Survey.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
FoodNet Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
none
FoodNet Population Survey
Attachment C. FoodNet Population Survey.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
18,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
18,000
0
0
0
0
18,000
Annual IC Time Burden (Hours)
6,000
0
0
0
0
6,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.
