OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

American Healthy Homes Survey II

IC 226989 under ICR 201912-2539-001 · OMB 2539-0026.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
AHHS II Appendix B Title X.doc Other-Appendix B
AHHS II Appendix D IRB Protocol Approval 12.6.16.pdf Other-Protcol approval with modifica
Appendix F Nonresponse follow-up questionnaire.HUD._21nov17.docx Other-Appendix F
AHHS II Appendix A_Field Protocols Questionnaire Informed Consent._21nov17.docx Other-Appendix A

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-Appendix B AHHS II Appendix B Title X.doc Yes Yes Fillable Printable
Other-Protcol approval with modification AHHS II Appendix D IRB Protocol Approval 12.6.16.pdf Yes Yes Fillable Printable
Other-Appendix F Appendix F Nonresponse follow-up questionnaire.HUD._21nov17.docx Yes Yes Fillable Printable
Other-Appendix A AHHS II Appendix A_Field Protocols Questionnaire Informed Consent._21nov17.docx Yes Yes Fillable Printable

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 1,364 0 0 0 0 1,364
Annual IC Time Burden (Hours) 2,441 0 0 0 0 2,441
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.