Information Collection

Methodological Projects

IC 229173 under ICR 202609-0920-001 · OMB 0920-0214.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Methodological Projects Methodological Projects	Form and Instruction
Methodological Projects Att 6 Methodological Projects 10-24-2023.docx	Form and Instruction
OMB0920-0214_Attachment 1-NHIS Redesign Questions for Cognitive Testing.docx Redesign Questions for Cognitive Testing	IC Document
OMB0920-0214_Attachment 4 - Screening Script.docx Screener	IC Document
OMB0920-0214_Attachment 6 - Data Collection Sheet.docx Respondent Data Collection Sheet	IC Document

IC Title:

Agency IC Tracking Number:

0920-0214

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
Form and Instruction	n/a			NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population

FR Citation: 49 FR 37693

Number of Respondents: 15,000

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	15,000	15,000
Annual IC Time Burden (Hours)	5,000	5,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Redesign Questions for Cognitive Testing		09/03/2026
Screener		09/03/2026
Respondent Data Collection Sheet		09/03/2026

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

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