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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
PRAMS Phase 8 - Spanish
Agency IC Tracking Number:
16BF
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
none
PRAMS Phase 8 - Spanish
Appendix 1 Qnne Spanish PRAMS final rev 101415.docx
Yes
Yes
Fillable Fileable
Form and Instruction
none
Screener
Appendix 3 rev Tele Screener Span PRAMS 101415.docx
Yes
Yes
Fillable Fileable
Form
none
Respondent Data Sheet
Appendix 5 Resp Data Collection Sheet Spanish PRAMS.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:
Health adn Demogrpahic Surveys Conducted in Probability Samples of the US Population
FR Citation:
49 FR 37693
Number of Respondents:
68
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
68
0
68
0
0
0
Annual IC Time Burden (Hours)
34
0
34
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Letter to Dr. Schwab
0920-0222 10-day PRAMS Spanish final rev 101415.docx
10/14/2015
Advertisement/Flyer
Appendix 2a-d Ad&Flyer Spanish PRAMS.docx
10/14/2015
Consent
Appendix 4 Informed Consent Spanish PRAMS.docx
10/14/2015
Thank you Letter
Appendix 6 Thank You letter Spanish PRAMS.docx
10/14/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.