Information Collection Request
[NCHS] Collaborating Center for Questionnaire Design and Evaluation Research
ICR 202212-0920-003 · OMB 0920-0222 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0920-0222 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 0920-0222-23EC [NCHS] Collaborating Center For Questionnaire Design and Evaluation Research |
Form and Instruction | New | Repair queued |
 Att B 60-Day Published FRN 9_30_2022.pdf |
Supplementary Document | Uploaded 2022-12-14 | Repair queued |
 SSB_0222_12012022.docx |
Supporting Statement B | Uploaded 2022-12-02 | Repair queued |
| SSA_0222-12012022.docx |
Supporting Statement A | Uploaded 2022-12-02 | Repair queued |
| Att O Thank You Letter.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att N Explain Cog Interview.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att M Sample Resp Data Collect Sheet.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att L Sample Advance Letter.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att K Voice mail script.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att J Sample newspaper adv.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att I Sample flyer.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att H-1&H-2 IRB Approval Documentation.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att G Spec Consent Focus Group.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att F Spec Consent Cog Int.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att E Informed Consent.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att D Screening Script.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att C Nondisclosure Affidavit.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
| Att A Public Health Serv Act.docx |
Supplementary Document | Uploaded 2021-08-03 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 259654 |  [NCHS] Collaborating Center For Questionnaire Design and Evaluation Research |
Form and Instruction | New |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-0222 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202107-0920-010 |
| Agency Tracking No | 0920-0222 |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |