View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Risk and Benefit Perception Scale Development Focus Groups	Agency IC Tracking Number:

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
Other-Screener			Appendix A_Screener.docx		Yes	Yes	Fillable Printable
Other-Moderator Guide			Appendix B_Moderator Guide.docx		Yes	Yes	Fillable Printable
Other-Consent Form			Appendix C_Consent Form.docx		Yes	Yes	Fillable Printable

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: 360	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	360	0	0	0	0	0
Annual IC Time Burden (Hours)	189	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Justification memo	OMB Justification memo.doc	02/11/2013

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