Community Members - SMS Text Survey

ATSDR Communication Activities Survey (ACAS)

Documents and Forms

Document Name Document Type
Community Members - SMS Text Survey Form and Instruction
SMS Text Survey AttH SMS Text Survey 20201130.pptx Form and Instruction
SMS Text Survey AttH SMS Text Survey 20201130.pptx Form and Instruction

Information Collection (IC) Details

IC Title:	Community Members - SMS Text Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	SMS Text Survey	AttH SMS Text Survey 20201130.pptx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	8	8
Annual IC Cost Burden (Dollars)	193	193

Documents for IC

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.