View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

2021 AHS Cognitive Testing
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 No   Fillable Fileable
Form and Instruction 2 No   Fillable Fileable

General Government Central Records & Statistical Mgt

 

165 0
   
Individuals or Households
 
   91 %

  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 165 0 165 0 0 0
Annual IC Time Burden (Hours) 56 0 56 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Memo 07/30/2020
Screener 07/06/2020
BOC and Craigslist Ads 06/17/2020
Ad Flyer 06/17/2020
Consent Form 07/06/2020
Previously Approved Universal Screener w/ privacy language 07/06/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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