Information Collection

High-Frequency Surveys Program/Household Pulse Survey

IC 263027 under ICR 202310-0607-004 · OMB 0607-1029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-1029 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Part A, Attachment High-Frequency Surveys Program/Household Pulse Survey	Form
Part A, Attachment Part A, Attachment A_Phase 4.0 Questionnaire Part A, Attachment A_Phase 4.0 Questionnaire_10.17.23.docx	Form
Part A, Attachment Part A, Attachment A_Phase 4.0 Questionnaire Part A, Attachment A_Phase 4.0 Questionnaire_11.20.23.docx	Form

IC Title:

High-Frequency Surveys Program/Household Pulse Survey

Agency IC Tracking Number:

0607-XXXX

Is this a Common Form? No

IC Status: New

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	Part A, Attachment A_Phase 4.0 Questionnaire	Part A, Attachment A_Phase 4.0 Questionnaire	Part A, Attachment A_Phase 4.0 Questionnaire_11.20.23.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 198,450

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	198,450	198,450
Annual IC Time Burden (Hours)	66,084	66,084
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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