Information Collection

Tuberculosis Education Materials for Classified Immigrants

IC 231138 under ICR 201711-0920-019 · OMB 0920-1071.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1071 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-1071 Tuberculosis Education Materials for Classified Immigrants Form and Instruction
0920-1071 Att C_B1 Key Informant Interview Guide Att C - B1 Key Informant Interview Guide MX.DOCX Form and Instruction
0920-1071 Att D_B2 Key Information Interview Guide--MX Att D - B2 Key Informant Interview Guide MX.DOCX Form and Instruction
0920-1071 Att E_B1 Key Information Interview Guide -- US Att E - B1 Key Informant Interview Guide US.DOCX Form and Instruction
0920-1071 Att F_B2 Key Informant Interview Guide -- US Att F - B2 Key Informant Interview Guide US.DOCX Form and Instruction
Request Approval_TB Education Materials.docx Request for APPROVAL IC Document
Att A - B1 Sample Education Materials.docx Att A: B1 Sample Education Materials IC Document
Att B - B2 Sample Education Materials.docx Att B: B2 Sample Education Materials IC Document
Att G - Approach Script.docx Att G_B1B2 Approach Script IC Document
Att H - Non-research determination.pdf Att H_Non Research Determination IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Tuberculosis Education Materials for Classified Immigrants	Agency IC Tracking Number:	0920-1071 (18ABU)

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	0920-1071	Att C_B1 Key Informant Interview Guide	Att C - B1 Key Informant Interview Guide MX.DOCX	No	Paper Only
Form and Instruction	0920-1071	Att D_B2 Key Information Interview Guide--MX	Att D - B2 Key Informant Interview Guide MX.DOCX	No	Paper Only
Form and Instruction	0920-1071	Att E_B1 Key Information Interview Guide -- US	Att E - B1 Key Informant Interview Guide US.DOCX	No	Paper Only
Form and Instruction	0920-1071	Att F_B2 Key Informant Interview Guide -- US	Att F - B2 Key Informant Interview Guide US.DOCX	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 70	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	70	70
Annual IC Time Burden (Hours)	129	129
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Request for APPROVAL	Request Approval_TB Education Materials.docx	04/25/2018
Att A: B1 Sample Education Materials	Att A - B1 Sample Education Materials.docx	04/25/2018
Att B: B2 Sample Education Materials	Att B - B2 Sample Education Materials.docx	04/25/2018
Att G_B1B2 Approach Script	Att G - Approach Script.docx	04/25/2018
Att H_Non Research Determination	Att H - Non-research determination.pdf	04/25/2018

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