OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Respondent Screener

IC 192850 under ICR 201102-0920-004 · OMB 0920-0858.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Respondent Screener
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Respondent screener 16-17 year olds Attachment_3_Screener Young Adults 16-17 (2).doc No   Paper Only
Form none Respondent screener parents of children 5-12 years old Attachment_5_Screener parents.doc No   Paper Only
Form none Respondent screener 18-18 year olds Attachment_4_Screener Young Adults 18-19.doc No   Paper Only

Health Illness Prevention

Epidemiologic Studies and Surveillance of Disease Problems  57 FR 62812

120 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 120 0 0 0 0 120
Annual IC Time Burden (Hours) 24 0 0 0 0 24
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.