Information Collection

ATUS Diary Recall Research

IC 270560 under ICR 202502-1220-005 · OMB 1220-0141.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Appendix A ATUS Diary Recall Research	Form and Instruction
Form Appendix A Cognitive Interview Protocol ATUS Diary Recall Research	Form and Instruction
Form Appendix B Online Survey ATUS Diary Recall Research	Form and Instruction
Form Appendix C Screening Questions for Cognitive Interviews ATUS Diary Recall Research	Form
Appendix A Cognitive Interview Protocol ATUS Diary Recall Research_Appendix A Final.docx	Form and Instruction
Appendix A Cognitive Interview Protocol ATUS Diary Recall Research_Appendix A Final.docx	Form and Instruction
Appendix B Online Survey ATUS Diary Recall Research_Appendix B_Revised.docx	Form and Instruction
Appendix B Online Survey ATUS Diary Recall Research_Appendix B_Revised.docx	Form and Instruction
Appendix C Screening Questions for Cognitive Interviews ATUS Diary Recall Research_Appendix C.docx	Form
Appendix C Screening Questions for Cognitive Interviews ATUS Diary Recall Research_Appendix C.docx	Form
ATUS Diary Recall Research_for OMB_Final.docx Note to Reviewer - ATUS Diary Recall Research	IC Document
ATUS Diary Recall Research_for OMB_Final.docx Note to Reviewer - ATUS Diary Recall Research	IC Document
ATUS Diary Recall Research_Appendix D.docx Appendix D - Ads for Respondents	IC Document
ATUS Diary Recall Research_Appendix D.docx Appendix D - Ads for Respondents	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Appendix A	Yes	No	Printable Only
Form and Instruction	Appendix B	Yes	Yes	Fillable Fileable
Form	Appendix C	Yes	No	Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,560

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 96 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,560	1,560
Annual IC Time Burden (Hours)	410	410
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Note to Reviewer - ATUS Diary Recall Research		08/30/2024
Appendix D - Ads for Respondents		08/30/2024

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

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