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Participants Follow-up Year 3 to 6
The Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)(NHLBI)
OMB: 0925-0584
IC ID: 199868
OMB.report
HHS/NIH
OMB 0925-0584
ICR 201406-0925-002
IC 199868
( )
Documents and Forms
Document Name
Document Type
Form 3
Participants Follow-up Year 3 to 6
Form and Instruction
3 Interview
Interview Form Contact Yr3_English.doc
Form and Instruction
4 Interview
Interview Form Contact Yr4_English.doc
Form and Instruction
5 Interview
Interview Form Contact Yr 5_English.doc
Form and Instruction
6 Interview
Interview Form Contact Yr6_English.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Participants Follow-up Year 3 to 6
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 and Instruction
3
Interview
Interview Form Contact Yr3_English.doc
Yes
Yes
Fillable Fileable
Form and Instruction
4
Interview
Interview Form Contact Yr4_English.doc
Yes
Yes
Fillable Fileable
Form and Instruction
5
Interview
Interview Form Contact Yr 5_English.doc
Yes
Yes
Fillable Fileable
Form and Instruction
6
Interview
Interview Form Contact Yr6_English.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
9,334
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
-9,334
0
0
9,334
Annual IC Time Burden (Hours)
0
0
-2,334
0
0
2,334
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.