Information Collection

NSCH Crowdsourcing Cognitive Interviews

IC 241767 under ICR 201909-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 NSCH Crowdsourcing Cognitive Interviews	Form and Instruction
1 Survey Content for Participants with a Child Aged 0-5 OMB letter attachment 1_Survey Content for Participants with a Child Aged 0-5_Updated 06292020.docx	Form and Instruction
2 Survey Content for Participants with a Child Age OMB letter attachment 2_Survey Content for Participants with a Child Aged 6 to 17_Updated 06292020.docx	Form and Instruction
3 Qualtrics Screenshots OMB letter attachment 3_Qualtrics Survey Screen Shot Examples.docx	Form and Instruction
Crowdsourcing Cognitive Interviews OMB letter_FINAL.docx OMB Memo	IC Document

IC Title:

NSCH Crowdsourcing Cognitive Interviews

Agency IC Tracking Number:

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	Available Electronically?	Electronic Capability
Form and Instruction	3	Qualtrics Screenshots	OMB letter attachment 3_Qualtrics Survey Screen Shot Examples.docx	No	Fillable Fileable
Form and Instruction	1	Survey Content for Participants with a Child Aged 0-5	OMB letter attachment 1_Survey Content for Participants with a Child Aged 0-5_Updated 06292020.docx	No	Fillable Fileable
Form and Instruction	2	Survey Content for Participants with a Child Age	OMB letter attachment 2_Survey Content for Participants with a Child Aged 6 to 17_Updated 06292020.docx	No	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	Crowdsourcing Cognitive Interviews OMB letter_FINAL.docx	05/11/2020

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