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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
2022/2023 Research and Development Survey (RANDS) and Cognitive Interviews
Agency IC Tracking Number:
0920-0222-22IB
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
Form and Instruction
None
2022/2023 RANDS Survey and Cognitive Interviews
Attachment 1 - Cognitive Interview and RANDS 2022&2023 Questionnaire-8.11.22.docx
Yes
Yes
Fillable Fileable
Form and Instruction
None
Respondent Data Collection Sheet
Attachment 2- Respondent Data Collection Sheet_07 08 2022.docx
Yes
Yes
Fillable Fileable
Form and Instruction
None
Screening Scripts
Attachment 4a&b - Screening script_08112022.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
6,885
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
6,885
0
6,885
0
0
0
Annual IC Time Burden (Hours)
1,909
0
1,909
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Study Advertisement for Recruitment Purposes
Attachment 3- Non-Specific Advertisement_07 08 2022.docx
08/11/2022
Informed Consent
Attachment 5 - Informed Consent_08 11 2022.docx
08/11/2022
Thank-you Letter
Attachment 6- Thank you letter_07 08 2022.docx
08/11/2022
Data Retention Policy
Attachment 7-Data Retention Policy_07 08 2022.docx
08/11/2022
NORC CIPESA Protection Plan
Attachment 8 - NORC CIPESA Protection Plan_07 29 2022.docx
08/11/2022
NCHS Non-disclosure Affadavit for NORC Staff
Attachment 9 - NCHS Non-Disclosure Affidavit for NORC_08_11022.docx
08/11/2022
Justification to OMB for RANDS5 testing
OMB 10-day Letter_RANDS_20222023_08-30-2022 clean.docx
09/07/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.