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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
In-Home Food Safety Behaviors and Consumer Education: Annual Observational Study
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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-screening questionnaires
Appx E_Screening Questionnaires_6_28_17.docx
No
Paper Only
Other-screening questionnaires Spanish
Appx E_Screening Questionnaires__Span 11_7_17.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,999
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
1,999
0
0
0
0
1,999
Annual IC Time Burden (Hours)
2,942
0
0
0
0
2,942
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Study Design
Appx A_study design.docx
05/17/2017
Recruiting Ads
Appx B_recruiting ads.docx
05/17/2017
Recruiting Email
Appx C_Recruiting Email.docx
05/17/2017
Recruiting Sign
Appx D_Recruiting Sign.docx
05/17/2017
Recruiting Call Script
Appx F_Recruit Call Script.docx
05/17/2017
Confirmation Email
Appx G_Confirmation Email.docx
05/17/2017
Reminder Call Script
Appx H_Reminder Call Script.docx
05/17/2017
Consent Form
Appx J_Consent Form_5_10_17.docx
05/17/2017
Recipes and Instructions
Appx L_Recipes and Instructions.docx
05/17/2017
Recruiting Ads Spanish
Appx B_recruiting ads_Span 11_7_17.docx
11/14/2017
Recruiting Email Spanish
Appx C_Recruiting Email_Span 11_7_17.docx
11/14/2017
Recruiting Sign Spanish
Appx D_Recruiting Sign_Span 11_7_17.docx
11/14/2017
Recruiting Call Script Spanish
Appx F_Recruit Call Script_Span 11_7_17.docx
11/14/2017
Confirmation Email Spanish
Appx G_Confirmation Email_Span 11_7_17.docx
11/14/2017
Reminder Call Script Spanish
Appx H_Reminder Call Script_Span 11_7_17.docx
11/14/2017
Consent Form Spanish
Appx J_Consent Form_Span 11_7_17.docx
11/14/2017
Recipes and Instructions Spanish
Appx L_Recipes and Instructions_Span 11_7_17.docx
11/14/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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