Information Collection

ORS Structured Cognitive Testing - Addendum

IC 249341 under ICR 202009-1220-006 · OMB 1220-0141.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1220-0141 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachments 1-3 Survey Protocol ORS Structured Cognitive Testing - Addendum	Form and Instruction
Attachments 1-3 Survey Protocol Attachments 1 - 3 - Survey Protocol.docx	Form and Instruction
Note to Reviewer - ORS Structured Cognitive Testing - Addendum.docx Note to Reviewer - ORS Structured Cognitive Testing - Addendum	IC Document

IC Title:

ORS Structured Cognitive Testing - Addendum

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachments 1-3				Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 177

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	177	177
Annual IC Time Burden (Hours)	15	15
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to Reviewer - ORS Structured Cognitive Testing - Addendum		09/15/2021

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

Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].