Information Collection

Cognitive Testing of 2025 NSCH Questionnaire – EPA Items

IC 262734 under ICR 202508-0607-002 · OMB 0607-0725.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Cognitive Testing of 2025 NSCH Questionnaire – EPA Items	Form and Instruction
Form 1 Protocol Cognitive Testing of 2025 NSCH Questionnaire – EPA Items	Form and Instruction
1 Protocol 2025 NSCH EPA Items Cognitive Interviewing Protocol_OMB.docx	Form and Instruction
1 Protocol 2025 NSCH EPA Items Cognitive Interviewing Protocol_OMB.docx	Form and Instruction
2025 NSCH EPA Items Cognitive Interviewing OMB Letter.docx OMB Memo	IC Document
2025 NSCH EPA Items Cognitive Interviewing OMB Letter.docx OMB Memo	IC Document
2025 NSCH EPA Items Cognitive Interviewing Participant Screener_OMB.docx Screener	IC Document
2025 NSCH EPA Items Cognitive Interviewing Participant Screener_OMB.docx Screener	IC Document
2025 NSCH EPA Items Cognitive Interviewing Consent Form2_OMB.docx Consent Form	IC Document
2025 NSCH EPA Items Cognitive Interviewing Consent Form2_OMB.docx Consent Form	IC Document

IC Title:

Cognitive Testing of 2025 NSCH Questionnaire â EPA Items

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
Form and Instruction	1				No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

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	30	30
Annual IC Time Burden (Hours)	19	19
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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

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