Information Collection

Understanding Economic Risk for Low Income Families Survey

IC 250514 under ICR 202407-0990-002 · OMB 0990-0281.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A_Economic Risk Study Instrument 11-15-21.docx	Other-
Attachment A_Economic Risk Study Instrument 11-15-21.docx	Other-
0990-0281 Generic economic risk 11-16-21.docx Pilot Study for Understanding Economic Risk for Low Income Families Survey - Supporting Statement - Secion A	IC Document
0990-0281 Generic economic risk 11-16-21.docx Pilot Study for Understanding Economic Risk for Low Income Families Survey - Supporting Statement - Secion A	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Unchanged

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
Other-					No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Pilot Study for Understanding Economic Risk for Low Income Families Survey - Supporting Statement - Secion A		11/23/2021

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

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