CHMC-Testing Educational Campaign Materials with African American and Hispanic Audiences

CDC and ATSDR Health Message Testing System

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Document Name Document Type
Attachment 2.pdf Other-PDF
Attachment 3.pdf Other-PDF
Attachment 4.pdf Other-PDF
Attachment 1.pdf Attachment 1 – Testing Plan and Burden Hours Table IC Document
HMTS Expedited Review Form 12 18 2014.docx Health Message Testing System Expedited Review Form IC Document
List of Attachments.pdf List of Attachments IC Document

Information Collection (IC) Details

IC Title:	CHMC-Testing Educational Campaign Materials with African American and Hispanic Audiences	Agency IC Tracking Number:	15IR

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-PDF	Attachment 2.pdf	Yes	Yes	Fillable Printable
Other-PDF	Attachment 3.pdf	Yes	Yes	Fillable Printable
Other-PDF	Attachment 4.pdf	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,800	3,800
Annual IC Time Burden (Hours)	1,584	1,584
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 1 – Testing Plan and Burden Hours Table	Attachment 1.pdf	01/07/2015
Health Message Testing System Expedited Review Form	HMTS Expedited Review Form 12 18 2014.docx	01/07/2015
List of Attachments	List of Attachments.pdf	01/07/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.