View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0920-1122	ICR Reference No: 201601-0920-013
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15BHD
Title: Congenital Heart Survey to Recognize Outcomes, Needs, and Well-Being
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/06/2016
	Date Received in OIRA: 02/12/2016
Terms of Clearance: Approved consistent with the understanding that incentives will be provided as follows: $5 prepaid incentive sent with the survey, and a $10 incentive contingent upon completion of the survey.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	12 Months From Approved
Responses	7,565	0	0
Time Burden (Hours)	2,254	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	7,565	7,565
Annual Time Burden (Hours)	2,254	2,254
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR. Burden totals may be off due to rounding.

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