Information Collection

[OADC] Still Going Strong Campaign Expansion Pilot Testing Survey

IC 262195 under ICR 202108-0920-006 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Survey Invitation [OADC] Still Going Strong Campaign Expansion Pilot Testing Survey	Form and Instruction
General Older Adults Survey [OADC] Still Going Strong Campaign Expansion Pilot Testing Survey	Form and Instruction
Tribal Elders Survey [OADC] Still Going Strong Campaign Expansion Pilot Testing Survey	Form and Instruction
Survey Invitation Att. C. Survey invitation.pdf	Form and Instruction
General Older Adults Survey Att. D. General Older Adults Survey.docx	Form and Instruction
Tribal Elders Survey Att. E. Tribal Elders SGS Survey.docx	Form and Instruction
Att. A. Privacy Act-Determination HMT-Still Going Strong.pdf Privacy Assessment	IC Document
Att. B. Project Description Still Going Strong Campaign_final.docx Project Description	IC Document
Att. F. CDC Radio 30 MIX 8-7-23 (2).mp3 Radio edit	IC Document
Expedited Form Request HMT-Still Going Strong_final.pdf Expedited Form Request	IC Document

IC Title:

[OADC] Still Going Strong Campaign Expansion Pilot Testing Survey

Agency IC Tracking Number:

0920-0572-23IF

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,400	1,400
Annual IC Time Burden (Hours)	128	128
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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