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Federal forms, ICRs, and supporting documents

Information Collection

Panel Replenishment Household Screening Respondent

IC 216700 under ICR 202004-0910-008 · OMB 0910-0815.

Documents and Forms
Document Name
Document Type
Other-Questionnaires - English
Other-Questionnaires - Spanish
Information Collection (IC) Details

View Information Collection (IC)

Panel Replenishment Household Screening Respondent
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Questionnaires - English Attachment_1_Questionnaires_English_CLEAN_042220.pdf Yes Yes Fillable Fileable
Other-Questionnaires - Spanish Attachment_2_Questionnaires_Spanish_CLEAN_042220.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

38,280 0
   
Individuals or Households
 
   0 %

  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 12,632 0 0 0 0 12,632
Annual IC Time Burden (Hours) 1,642 0 0 0 0 1,642
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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