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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Validity Study of IDD Questions_ IDD Round 2
Agency IC Tracking Number:
0920-22BF
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
0920-22BF
Att 5a-5c Respondent Data Collection Sheet
Att 5a-5c Respondent Data Collection Sheet 8_11_21 CLEAN.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:
150
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
150
0
150
0
0
0
Annual IC Time Burden (Hours)
103
0
103
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 2a-2c Advertisements 8_11_21 CLEAN
Att 2a-2c Advertisements 8_11_21 CLEAN.docx
12/07/2021
IDD Round 2 10-day letter
IDD Round 2 10-day letter_112921.docx
12/07/2021
Att 3 Telephone Screening Script 110421 CLEAN
Att 3 Telephone Screening Script 110421 CLEAN.docx
12/07/2021
Att 4a-4h Informed Consent 8_11_21 CLEAN
Att 4a-4h Informed Consent 8_11_21 CLEAN.docx
12/07/2021
Att 6 Thank you note 8_11_21 CLEAN
Att 6 Thank you note 8_11_21 CLEAN.docx
12/07/2021
Att 7 Follow-up Discussion 8_11_21 CLEAN
Att 7 Follow-up Discussion 8_11_21 CLEAN.docx
12/07/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.