View Information Collection (IC)

View Information Collection (IC)

CCQDER - Cognitive Testing Questions for the 2022 NAMCS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 0920-0222 Telephone Screening Script – Respondent recruited from newspaper advertisement/flyer NAMCS OMB Attachment 4a 4b_Telephone Screening Script_revised Assurance_01112022.docx No   Paper Only
Form 0920-0222 Adult Informed Consent Form for NAMCS OMB Attachment 5a 5b_Informed Consent_revised Assurance.docx No   Fillable Fileable
Form 0920-0222 Respondent Data Collection Sheet NAMCS OMB Attachment 6a 6b_Data Collection Sheet_revised Assurance.docx Yes Yes Fillable Fileable
Form 0920-0222 Respondent Debriefing Interview (virtual interviews) NAMCS OMB Attachment 8_Follow Up Interview_revised Assurance.docx Yes No Fillable Fileable
Form and Instruction 1a Questionnaire NAMCS OMB Attachment 1a_Questionnaire_revised Assurance.docx Yes Yes Fillable Fileable
Form and Instruction 1b Questionnaire NAMCS OMB Attachment 1b_Questionnaire_revised Assurance.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

40 0
   
Individuals or Households
 
   75 %

  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 40 0 40 0 0 0
Annual IC Time Burden (Hours) 29 0 29 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
NAMCS 10-day Letter NAMCS 10-day-letter 01112022_SK.docx 01/27/2022
Provenance of Questions to be Cognitively Tested NAMCS OMB Attachment 2_Question Provenance.docx 01/27/2022
Participants Wanted for Research Study Advertisement NAMCS OMB Attachment 3a 3b_Advertisements.docx 01/27/2022
Thank You Letter NAMCS OMB Attachment 7_Thank You Letter.docx 01/27/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.