Information Collection

In-Home Food Safety Behaviors and Consumer Education: Web-Based Survey

IC 237310 under ICR 201908-0583-001 · OMB 0583-0178.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0178 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appx_A1_Web Survey Instrument__Hard copy_9_12_19.docx	Other-web survey hard copy
Appx_A2_Web Survey Instrument_Programmed_9_12_19.docx	Other-web survey screenshots
Appx_B_Survey Invitation_8_7_19.docx Survey Invitation	IC Document
Appx C_IRB_Exemption_8_7_19.pdf IRB Exemption	IC Document

IC Title:

In-Home Food Safety Behaviors and Consumer Education: Web-Based Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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-web survey hard copy			Appx_A1_Web Survey Instrument__Hard copy_9_12_19.docx		Yes	Yes	Fillable Fileable
Other-web survey screenshots			Appx_A2_Web Survey Instrument_Programmed_9_12_19.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 55 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	1,076	1,076
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Survey Invitation	Appx_B_Survey Invitation_8_7_19.docx	08/09/2019
IRB Exemption	Appx C_IRB_Exemption_8_7_19.pdf	08/09/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.