View Information Collection (IC)

View Information Collection (IC)

IC Title:	GenIC for CCQDER's RANDS 9	Agency IC Tracking Number:	0920-0222-23IG

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	1	qustionnaire	Attachment 1 - RANDS 9 Questionnaire_FINAL 11 02 2023.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: 49,800	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	49,800	0	49,800	0	0	0
Annual IC Time Burden (Hours)	12,450	0	12,450	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9	Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9.docx	10/16/2023
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9	Attachment 3 - NORC CIPESA Protection Plan_RANDS 9.docx	10/16/2023
Attachment 4 – Comparison of Topics between RANDS 8 & 9	Attachment 4 – Comparison of Topics between RANDS 8 & 9.docx	10/16/2023
SSB	SSB-RANDS 9_9.24.23.docx	10/16/2023
SSA for RANDS 9	SSA-RANDS 9_REVISED_11 02 2023_FINAL_amb.docx	11/03/2023

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