Information Collection

NCHS Rapid Surveys System

IC 260111 under ICR 202308-0920-004 · OMB 0920-1408.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1408 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0920-23GY NCHS Rapid Surveys System	Form and Instruction
0920-23GY RSS2_Full_OMB_Questionnaire_July182023 RSS2_Full_OMB_Questionnaire_July182023.docx	Form and Instruction
0920-23GY RSS2_Full_OMB_Questionnaire_July182023 RSS2_Full_OMB_Questionnaire_July182023.docx	Form and Instruction
0920-1408 NCHS Rapid Survey System Round 1 Questionnaire SSA_Att D RSS1 Full Questionnaire 30-Day.docx	Form and Instruction
30_Day_FRN_Round2_July182023.docx 30 Day FRN	IC Document
30_Day_FRN_Round2_July182023.docx 30 Day FRN	IC Document
RSS Round 2 Nonsubstantive Change Request.docx RSS Round 2 Nonsubstantive Change Request	IC Document
RSS Round 2 Nonsubstantive Change Request.docx RSS Round 2 Nonsubstantive Change Request	IC Document

IC Title:

NCHS Rapid Surveys System

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
Form and Instruction	0920-23GY	RSS2_Full_OMB_Questionnaire_July182023	RSS2_Full_OMB_Questionnaire_July182023.docx		Yes	Yes	Fillable Fileable
Form and Instruction	0920-1408	NCHS Rapid Survey System Round 1 Questionnaire	SSA_Att D RSS1 Full Questionnaire 30-Day.docx	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: 13,120

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	13,120	-70,960	84,080
Annual IC Time Burden (Hours)	4,387	-23,692	28,079
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
30 Day FRN	30_Day_FRN_Round2_July182023.docx	08/07/2023
RSS Round 2 Nonsubstantive Change Request	RSS Round 2 Nonsubstantive Change Request.docx	08/07/2023

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