View Information Collection (IC)

View Information Collection (IC)

Screener Verification
No Modified

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screener Verification ATT_L2 _Screener Verification 091917.doc Yes Yes Fillable Fileable

Health Public Health Monitoring

09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population  49 FR 37693

1,500 0
Individuals or Households
   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 1,500 0 0 0 0 1,500
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 1,320 0 1,320 0 0 0

Title Document Date Uploaded
Verfification Questionnaire Description ATT_L1_VerificationQues Descrip 040918.doc 04/25/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.