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 Name	Document 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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix B	Yes	Yes	Fillable Printable
Other-Protcol approval with modification	Yes	Yes	Fillable Printable
Other-Appendix F	Yes	Yes	Fillable Printable
Other-Appendix A	Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Community and Regional Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,364	1,364
Annual IC Time Burden (Hours)	2,441	2,441
Annual IC Cost Burden (Dollars)	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.

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