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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Developmental Projects & Special Studies Testing
Agency IC Tracking Number:
0920-05
Is this a Common Form?
No
IC Status:
Unchanged
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
0920-0950
Introductory Letter for SP Questionnaire
Att_13a_Introductory Letter for SP Questionnaire_v6_201029.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0950
NHANES Follow-Up Questionnaire
Att. 2 NHANES_Follow_up_Questionnaire_v9_04102022.pdf
NA
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0950
NHANES Refuser No Show Questionnaire
Att. 4 NHANES_Refuser_No_Show_v8_04102022.pdf
NA
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
09-20-0164 Health and Demographic Surveys Conducted in Probability Samples of the U.S. Population
FR Citation:
49 FR 37693
Number of Respondents:
3,500
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
3,500
0
0
0
0
3,500
Annual IC Time Burden (Hours)
10,500
0
0
0
0
10,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
MEC Follow-Up Letter
Att. 1 MEC FollowUp_Letter_02242022.docx
05/18/2022
MEC Refuser Letter
Att. 3 MEC Refusers_Letter_02242022.docx
05/18/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.