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Federal forms, ICRs, and supporting documents

Information Collection Request

Building the Capacity to Fluoridate: Key Informant Interviews to Understanding Community Water Fluoridation

ICR 200402-0920-006 · OMB 0920-0637 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
7105 Building the Capacity to Fluoridate: Key Informant Interviews to Understanding Community Water Fluoridation Migrated
ICR Details
0920-0637 200402-0920-006
Historical Active
HHS/CDC
Building the Capacity to Fluoridate: Key Informant Interviews to Understanding Community Water Fluoridation
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 06/07/2004
Retrieve Notice of Action (NOA) 02/12/2004
Approved consistent with the clarification provided in CDC memo submitted to OMB on 06/02/04. CDC will not offer incentives to respondents for participating in this information collection.
  Inventory as of this Action Requested Previously Approved
05/31/2005 05/31/2005
80 0 0
140 0 0
0 0 0
This study will explore the dynamics of local fluoridation referenda campaigns and the factors that influence the outcomes of these campaigns. The primary data collection activity will be interviews with key informants from these campaigns.
None
None
No
1
IC Title Form No. Form Name
Building the Capacity to Fluoridate: Key Informant Interviews to Understanding Community Water Fluoridation
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 80 0 0 80 0 0
Annual Time Burden (Hours) 140 0 0 140 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/12/2004