Information Collection

Pool Safely Focus Group

IC 245952 under ICR 202206-3041-001 · OMB 3041-0136.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3041-0136 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Pool Safely Focus Group Materials.pdf	Instruction
Pool Safely Focus Group Materials.pdf	Instruction
Pool Safely Focus Group Guide.pdf	Instruction
Pool Safely Focus Group Guide.pdf	Instruction
Screener PoolSafely Screener.docx	Form and Instruction
Screener PoolSafely Screener.docx	Form and Instruction
Pool Safely Focus Group Supporting Statement.pdf Pool Safely FG Supporting Statement	IC Document
Pool Safely Focus Group Supporting Statement.pdf Pool Safely FG Supporting Statement	IC Document

IC Title:

Pool Safely Focus Group

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Pool Safely Focus Group Materials.pdf	Yes	Yes	Fillable Printable
Instruction			Pool Safely Focus Group Guide.pdf	No		Fillable Fileable
Form and Instruction	NA	Screener	PoolSafely Screener.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 48

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	48	48
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Pool Safely FG Supporting Statement	Pool Safely Focus Group Supporting Statement.pdf	02/23/2021

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