Information Collection

National Survey of Children's Health

IC 220525 under ICR 201903-0607-004 · OMB 0607-0990.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0990 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NSCH-S1 & NSCH-T1 National Survey of Children's Health	Form
Appendix D - 2019 NSCH Envelope Design Drafts_final.pdf	Other-2019 NSCH Envelope Design Draf
Appendix E - 2019 NSCH Production Sample Letters.pdf	Other-2019 NSCH Production Sample Le
Appendix F – 2019 NSCH Screener Card Test Sample Letters.pdf	Other-2019 NSCH Screener Card Test L
NSCH-S1 & NSCH-T1 2019 NSCH Questionnaire Content Revisions Appendix A - 2019 NSCH Questionnaire Content Revisions.pdf	Form

IC Title:

National Survey of Children's Health

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NSCH-S1 & NSCH-T1	2019 NSCH Questionnaire Content Revisions	Appendix A - 2019 NSCH Questionnaire Content Revisions.pdf	Yes	Yes	Fillable Fileable
Other-2019 NSCH Envelope Design Drafts			Appendix D - 2019 NSCH Envelope Design Drafts_final.pdf	Yes	Yes	Fillable Fileable
Other-2019 NSCH Production Sample Letters			Appendix E - 2019 NSCH Production Sample Letters.pdf	Yes	Yes	Fillable Fileable
Other-2019 NSCH Screener Card Test Letter			Appendix F â 2019 NSCH Screener Card Test Sample Letters.pdf	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title: SORN Census 3

FR Citation: 77 FR 18205

Number of Respondents: 96,549

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 65 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	96,549	-170,357	266,906
Annual IC Time Burden (Hours)	20,371	3,798	16,573
Annual IC Cost Burden (Dollars)	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.