View Information Collection (IC)

View Information Collection (IC)

Gender X Marker 0920-22AY
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Draft Modified Form with Questions to be Tested Attachment 1 - Passport Application Form.docx Yes Yes Fillable Printable
Form and Instruction n/a Screening Questions for Potential Respondents Attachment 3 - Screener.docx Yes Yes Fillable Fileable
Form and Instruction n/a Informed Consent Attachment 4v2 - Informed Consent.docx Yes Yes Fillable Fileable
Form and Instruction n/a Respondent Data Collection Sheet Attachment 5- Respondent Data Collection Sheet.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population  49 FR 37693

150 0
   
Individuals or Households
 
   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 150 0 150 0 0 0
Annual IC Time Burden (Hours) 129 0 129 0 0 0
Annual IC Cost Burden (Dollars) 1,074 0 1,074 0 0 0

Title Document Date Uploaded
Project Description and Justification (10-day letter) Gender X 10-day-letter-111821 Clean SK.docx 11/18/2021
Recruitment Advertisement Attachment 2- Non-Specific Advertisement.docx 11/18/2021
Data Retention Policy Attachment 6-Data Retention Policy_ 102121.docx 11/18/2021
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.