High-Frequency Surveys Program/Household Pulse Survey Phase 4.1

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form Part A, Attachment High-Frequency Surveys Program/Household Pulse Survey Phase 4.1 Form
Part A, Attachment Part A, Attachment A_Phase 4.1 Questionnaire_v1 Part A, Attachment A_Phase 4.0 Questionnaire_11.20.23.docx Form
Part A, Attachment Part A, Attachment A_Phase 4.1 Questionnaire_v3 Part A, Attachment A_Phase 4.1 Questionnaire_v3.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	High-Frequency Surveys Program/Household Pulse Survey Phase 4.1	Agency IC Tracking Number:	0607-1029

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Part A, Attachment A_Phase 4.1 Questionnaire_v3	Part A, Attachment A_Phase 4.1 Questionnaire_v3	Part A, Attachment A_Phase 4.1 Questionnaire_v3.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 264,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	264,600	66,150	198,450
Annual IC Time Burden (Hours)	88,112	22,028	66,084
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.