Information Collection

GenIC for CCQDER's RANDS 9

IC 262818 under ICR 202504-0920-019 · OMB 0920-0222.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0222 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 GenIC for CCQDER's RANDS 9	Form and Instruction
Form 1 qustionnaire GenIC for CCQDER's RANDS 9	Form and Instruction
1 qustionnaire Attachment 1 - RANDS 9 Questionnaire_FINAL 11 02 2023.docx	Form and Instruction
1 qustionnaire Attachment 1 - RANDS 9 Questionnaire_FINAL 11 02 2023.docx	Form and Instruction
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9.docx Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9	IC Document
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9.docx Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9	IC Document
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9.docx Attachment 3 - NORC CIPESA Protection Plan_RANDS 9	IC Document
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9.docx Attachment 3 - NORC CIPESA Protection Plan_RANDS 9	IC Document
Attachment 4 – Comparison of Topics between RANDS 8 & 9.docx Attachment 4 – Comparison of Topics between RANDS 8 & 9	IC Document
Attachment 4 – Comparison of Topics between RANDS 8 & 9.docx Attachment 4 – Comparison of Topics between RANDS 8 & 9	IC Document
SSB-RANDS 9_9.24.23.docx SSB	IC Document
SSB-RANDS 9_9.24.23.docx SSB	IC Document
SSA-RANDS 9_REVISED_11 02 2023_FINAL_amb.docx SSA for RANDS 9	IC Document
SSA-RANDS 9_REVISED_11 02 2023_FINAL_amb.docx SSA for RANDS 9	IC Document

IC Title:

GenIC for CCQDER's RANDS 9

Agency IC Tracking Number:

0920-0222-23IG

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
Form and Instruction	1				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 49,800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	49,800	49,800
Annual IC Time Burden (Hours)	12,450	12,450
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9		10/16/2023
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9		10/16/2023
Attachment 4 â Comparison of Topics between RANDS 8 & 9		10/16/2023
SSB		10/16/2023
SSA for RANDS 9		11/03/2023

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

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