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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Food Safety Communication Evaluation: Focus Groups Assessing Food Safety Messages, Knowledge, and Attitudes
Agency IC Tracking Number:
0920-1154-22CW
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
0920-1154
Eligibility and Demographic Screener
Attachment #1 - Eligibility and Demographic Screener_25Feb22.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1154
Focus Group Moderator Guide - General
Attachment #3 (1) - Focus Group Moderator Guide-Gen_ AA_ Hisp_25Feb22.docx
Yes
No
Fillable Fileable
Form and Instruction
0920-1154
Focus Group Moderator Guide - Parents
Attachment #3 (2) - Focus Group Moderator Guide-Parents_25Feb22.docx
Yes
No
Fillable Fileable
Form and Instruction
0920-1154
Focus Group Moderator Guide - Pregnant
Attachment #3 (3)- Focus Group Moderator Guide-Pregnant_25Feb22.docx
Yes
No
Fillable Fileable
Form and Instruction
0920-1154
Respondent Technology Screener
Attachment #7 - Respondent Technology Screener_25Feb22.docx
Yes
No
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:
4,844
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
4,844
0
4,844
0
0
0
Annual IC Time Burden (Hours)
646
0
646
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Recruitment Materials
Attachment #2 - Recruitment Materials_25Feb22.docx
03/02/2022
Privacy Agreement
Attachment #4 - Privacy Agreement 25Feb22.docx
03/02/2022
Messages and Materials for Testing
Attachment #5 - Messages and Materials for Testing_25Feb22.docx
03/02/2022
Consent Form
Attachment #6 - Respondent Consent Form_25Feb22.docx
03/02/2022
Standard Invitation
Attachment #8 - Standard Invitation_25Feb22.docx
03/02/2022
Confirmation Email
Attachment #9 - Participant Confirmation Email25Feb22.docx
03/02/2022
GenIC Template Form
GenIC Request_25Feb22.docx
03/02/2022
SSA
Supporting Statement A_25Feb22.docx
03/02/2022
SSB
Supporting Statement B_25Feb22.docx
03/02/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.