Information Collection

Developmental Projects & Special Studies Testing

IC 245124 under ICR 202209-0920-001 · OMB 0920-0950.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0950 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0950 Developmental Projects & Special Studies Testing Form and Instruction
0920-0950 Introductory Letter for SP Questionnaire Att_13a_Introductory Letter for SP Questionnaire_v6_201029.docx Form and Instruction
0920-0950 NHANES Follow-Up Questionnaire Att. 2 NHANES_Follow_up_Questionnaire_v9_04102022.pdf Form and Instruction
0920-0950 NHANES Refuser No Show Questionnaire Att. 4 NHANES_Refuser_No_Show_v8_04102022.pdf Form and Instruction
Att. 1 MEC FollowUp_Letter_02242022.docx MEC Follow-Up Letter IC Document
Att. 3 MEC Refusers_Letter_02242022.docx MEC Refuser Letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Developmental Projects & Special Studies Testing	Agency IC Tracking Number:	0920-05

Is this a Common Form? No		IC Status: Unchanged

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	0920-0950	Introductory Letter for SP Questionnaire	Att_13a_Introductory Letter for SP Questionnaire_v6_201029.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-0950	NHANES Follow-Up Questionnaire	Att. 2 NHANES_Follow_up_Questionnaire_v9_04102022.pdf	NA	Yes	Yes	Fillable Fileable
Form and Instruction	0920-0950	NHANES Refuser No Show Questionnaire	Att. 4 NHANES_Refuser_No_Show_v8_04102022.pdf	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population	FR Citation: 49 FR 37693

Number of Respondents: 3,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,500	3,500
Annual IC Time Burden (Hours)	10,500	10,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
MEC Follow-Up Letter	Att. 1 MEC FollowUp_Letter_02242022.docx	05/18/2022
MEC Refuser Letter	Att. 3 MEC Refusers_Letter_02242022.docx	05/18/2022

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