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Interviews Observation Form (Screener Verification)
[NCHS] National Survey of Family Growth
OMB: 0920-0314
IC ID: 216268
OMB.report
HHS/CDC
OMB 0920-0314
ICR 202404-0920-003
IC 216268
( )
Documents and Forms
Document Name
Document Type
Form 0920-0314
Interviews Observation Form (Screener Verification)
Form and Instruction
Form 0920-0314
Interviews Observation Form (Screener Verification)
Form and Instruction
0920-0314 INTERVIEW OBSERVATION FORM
ATT-L-InterviewObsForm_revJun2021.docx
Form and Instruction
0920-0314 INTERVIEW OBSERVATION FORM
ATT-L-InterviewObsForm_revJun2021.docx
Form and Instruction
ATT-K-NSFG-VerificationProcedures.docx
In-person Interview Verification Procedures and Questionnaires for Screener Survey and Main Survey
IC Document
ATT-K-NSFG-VerificationProcedures.docx
In-person Interview Verification Procedures and Questionnaires for Screener Survey and Main Survey
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Interviews Observation Form (Screener Verification)
Agency IC Tracking Number:
0920-0314
Is this a Common Form?
No
IC Status:
Unchanged
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 and Instruction
0920-0314
INTERVIEW OBSERVATION FORM
ATT-L-InterviewObsForm_revJun2021.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
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:
250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
250
0
0
0
0
250
Annual IC Time Burden (Hours)
8
0
0
0
0
8
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
In-person Interview Verification Procedures and Questionnaires for Screener Survey and Main Survey
ATT-K-NSFG-VerificationProcedures.docx
07/28/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.