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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
NSCH Mail Materials Cognitive Testing
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
Form and Instruction
1
Mail Materials
NSCH 2019 Mail Materials for Cognitive Testing_OMB.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
30
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
30
0
30
0
0
0
Annual IC Time Burden (Hours)
36
0
36
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo
NSCH 2019 Mail Materials Cognitive Interviewing OMB Letter.docx
07/09/2019
Protocol
NSCH 2019 Mail Materials Cognitive Interviewing Protocol_OMB.docx
07/09/2019
Consent Form
NSCH 2019 Mail Materials Consent form_OMB.doc
07/09/2019
Telephone Screener
NSCH 2019 Mail Materials Participant Screener_OMB.docx
07/09/2019
Screener Roster
NSCH 2019 Mail Materials Screener Roster_OMB.docx
07/09/2019
Voucher
NSCH 2019 Mail Materials Voucher_OMB.docx
07/09/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.