Information Collection

Pilot Testing

IC 229814 under ICR 202510-0910-002 · OMB 0910-0932.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0932 NYTS Att H1_ NYTS Survey Questionnaire clean 20240520a.docx	Other-NYTS Survey Questionnaire
0932 NYTS Att H1_ NYTS Survey Questionnaire clean 20240520a.docx	Other-NYTS Survey Questionnaire

IC Title:

Pilot Testing

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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-NYTS Survey Questionnaire				N/A	No		Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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