Information Collection

Stimuli Development and Pretests for an Attentional Effects Study

IC 205722 under ICR 201106-0910-004 · OMB 0910-0695.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0695 can be found here:

Documents and Forms

Document Name Document Type
Appendix C -- Questionnaire.doc Other-Survey
Appendix A -- Screener.doc Other-Screener
Appendix D -- Consent Form.doc Appendix D -- Consent Form IC Document
Appendix B -- Recruitment and Reminder Emails.doc Appendix B -- Recruitment and Reminder Emails IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Stimuli Development and Pretests for an Attentional Effects Study	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			Appendix C -- Questionnaire.doc		Yes	Yes	Fillable Fileable Signable
Other-Screener			Appendix A -- Screener.doc		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,180	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	6,180	0	0	0	0	0
Annual IC Time Burden (Hours)	455	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix D -- Consent Form	Appendix D -- Consent Form.doc	02/07/2013
Appendix B -- Recruitment and Reminder Emails	Appendix B -- Recruitment and Reminder Emails.doc	02/07/2013

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