View Information Collection (IC)

View Information Collection (IC)

IC Title:	Discussion guide for focus groups	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
Instruction			Attachment 1b.doc		No	No	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 0920-0164 Health and Demographic Surveys Conducted in Probability Samples of the US Population	FR Citation: 49 FR 37693

Number of Respondents: 74	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 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	74	0	0	0	0	0
Annual IC Time Burden (Hours)	86	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Birth certificate form to begin discussion	Attachment 1a.doc	05/07/2009
Introduction to cognitive interview	Attachment 1c.doc	05/07/2009
Invitation to participate	Attachment 2.doc	05/07/2009
Justification	QDRL-OMB-DVS Collection of Birth Certificate Data-letter.doc	05/07/2009

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