Information Collection

In-Home Food Safety Behaviors and Consumer Education: Web-Based Survey

IC 237310 under ICR 202211-0583-001 · OMB 0583-0178.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2022 Appendix A_Web Survey Instrument.pdf	Other-web survey
2022 Appendix A_Web Survey Instrument.pdf	Other-web survey
Appx_B_Survey Invitation_8_19_20.docx Survey Invitation	IC Document
Appx_B_Survey Invitation_8_19_20.docx Survey Invitation	IC Document
Appx_C_IRB_Exemption_8_7_19.pdf IRB Exemption	IC Document
Appx_C_IRB_Exemption_8_7_19.pdf IRB Exemption	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-web survey			2022 Appendix A_Web Survey Instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 55 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	1,076	1,076
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Survey Invitation	Appx_B_Survey Invitation_8_19_20.docx	08/20/2020
IRB Exemption	Appx_C_IRB_Exemption_8_7_19.pdf	08/20/2020

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