View Information Collection (IC)

View Information Collection (IC)

IC Title:	PATH - Adults Household Screener/Field Test	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	2a	Household Screener/Field Test	2a. Household Screener Version 6.1 2012-08-16.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: NIH Privacy Act System of Records 09-25-0200 Clinical, Basic, Population-based research studies of NIH, HHS/NIH/OD	FR Citation: 67 FR 60741

Number of Respondents: 1,295	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	0	0	-1,295	0	0	1,295
Annual IC Time Burden (Hours)	0	0	-367	0	0	367
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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