Information Collection

Reinterview Study 2020

IC 214306 under ICR 202004-0920-006 · OMB 0920-0278.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0278 can be found here:

Documents and Forms

Document Name Document Type
Reinterview Study 2020 Form and Instruction
Reinterview Study 2020 Attachment L1 - Reinterview Study Questionnaire (2020).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Reinterview Study 2020	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Form and Instruction	none	Reinterview Study 2020	Attachment L1 - Reinterview Study Questionnaire (2020).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health Resources Utlization Statistics	FR Citation: 49 FR 37693

Number of Respondents: 42	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	42	37	5
Annual IC Time Burden (Hours)	11	10	1
Annual IC Cost Burden (Dollars)	1,232	1,212	20

Documents for IC

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.