Information Collection

Appendix A_NSCH-LC Screener and Topical Questionnaires

IC 261064 under ICR 202402-0607-006 · OMB 0607-1028.

Documents and Forms

Document Name Document Type
Form Appendix A_NSCH-LC Appendix A_NSCH-LC Screener and Topical Questionnaires Form
Form Appendix A_NSCH-LC Appendix A_NSCH-LC Screener and Topical Questionnaires Form
Appendix A_NSCH-LC Appendix A_NSCH-LC Screener and Topical Questionnaires Appendix A_NSCH-LC Screener and Topical Questionnaires.pdf Form
Appendix A_NSCH-LC Appendix A_NSCH-LC Screener and Topical Questionnaires Appendix A_NSCH-LC Screener and Topical Questionnaires.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Appendix A_NSCH-LC Screener and Topical Questionnaires	Agency IC Tracking Number:

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	Appendix A_NSCH-LC	Appendix A_NSCH-LC Screener and Topical Questionnaires	Appendix A_NSCH-LC Screener and Topical Questionnaires.pdf		Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 45,478	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	45,478	478	45,000
Annual IC Time Burden (Hours)	30,334	334	30,000
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.