Health Care Group Quarters Addendum

Generic Clearance for Questionnaire Pretesting Research

Documents and Forms

Document Name Document Type
Form 1 Health Care Group Quarters Addendum Form and Instruction
1 Recruitment emails Enclosure 2 - GQ health care cognitive testing recruitment emails.docx Form and Instruction
OMB Memo - First Addendum to notify OMB of change of recruiting method - GQ health care cognitive testing - v2.docx OMB Memo IC Document
Enclosure 1 - GQ health care cognitive testing OMB request letter.docx Initial OMB Memo for previosly approved package IC Document

Information Collection (IC) Details

IC Title:	Health Care Group Quarters Addendum	Agency IC Tracking Number:

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	1	Recruitment emails	Enclosure 2 - GQ health care cognitive testing recruitment emails.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	OMB Memo - First Addendum to notify OMB of change of recruiting method - GQ health care cognitive testing - v2.docx	09/19/2023
Initial OMB Memo for previosly approved package	Enclosure 1 - GQ health care cognitive testing OMB request letter.docx	09/19/2023

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