View Information Collection (IC)

View Information Collection (IC)

IC Title:	Conducting Testing on NHIS and NHANES Questions	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
Form	No number	Testing NHIS and NHANES Questions	Attachment 2-v3.docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: 09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the United States Population	FR Citation: 49 FR 37693

Number of Respondents: 30	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	30	0	0	0	0	0
Annual IC Time Burden (Hours)	30	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Recruitment Flyer	Attachment 1.doc	06/08/2010
10-Day Letter to Margo Schwab	QDRL OMB-10-day letter-NHIS Wellness & NHANES-v2.doc	06/08/2010

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