Information Collection Request

Health Related Behaviors Survey

ICR 202303-0720-002 · OMB 0720-0072 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
0720-HRBS_SSA_6.16.2023.docx Supporting Statement A Uploaded 2023-06-16 Repair queued
0720-HRBS_SSB_3.23.2023.docx Supporting Statement B Uploaded 2023-03-23 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
259689 Health Related Behaviors Survey Other-Survey New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
22,100 0
7,367 0
209,333 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Health Related Behaviors Survey

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 22,100 0 0 22,100 0 0
Annual Time Burden (Hours) 7,367 0 0 7,367 0 0
Annual Cost Burden (Dollars) 209,333 0 0 209,333 0 0


Reginfo record details
  No