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Federal forms, ICRs, and supporting documents

Information Collection

Behavioral Survey

IC 216377 under ICR 202305-0920-009 · OMB 0920-1080.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Behavioral Survey 0920-1080
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a Behavioral Survey (screenshots) Att 3b_Behavioral Survey Screen Shots.pdf Yes Yes Fillable Fileable
Form and Instruction n/a Behavioral Survey Att 3a_Behavioral Survey Instrument.docx Yes Yes Fillable Fileable

Health Illness Prevention

09-20-0160 Records of Subjects in Health Promotion and Education Studies  83 FR 6591

2,700 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 2,700 0 0 0 0 2,700
Annual IC Time Burden (Hours) 315 0 0 0 0 315
Annual IC Cost Burden (Dollars) 8,100 0 0 0 0 8,100

Title Document Date Uploaded
Behavioral Survey Instruction Card Att 5_Behavioral Survey Instruction Card.docx 05/23/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.