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American Healthy Homes Survey II
American Healthy Homes Survey II
OMB: 2539-0026
IC ID: 226989
OMB.report
HUD/OLBPPP
OMB 2539-0026
ICR 201912-2539-001
IC 226989
( )
Documents and Forms
Document Name
Document Type
AHHS II Appendix B Title X.doc
Other-Appendix B
AHHS II Appendix D IRB Protocol Approval 12.6.16.pdf
Other-Protcol approval with modifica
Appendix F Nonresponse follow-up questionnaire.HUD._21nov17.docx
Other-Appendix F
AHHS II Appendix A_Field Protocols Questionnaire Informed Consent._21nov17.docx
Other-Appendix A
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
American Healthy Homes Survey II
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Appendix B
AHHS II Appendix B Title X.doc
Yes
Yes
Fillable Printable
Other-Protcol approval with modification
AHHS II Appendix D IRB Protocol Approval 12.6.16.pdf
Yes
Yes
Fillable Printable
Other-Appendix F
Appendix F Nonresponse follow-up questionnaire.HUD._21nov17.docx
Yes
Yes
Fillable Printable
Other-Appendix A
AHHS II Appendix A_Field Protocols Questionnaire Informed Consent._21nov17.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Community and Regional Development
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
600
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
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
1,364
0
0
0
0
1,364
Annual IC Time Burden (Hours)
2,441
0
0
0
0
2,441
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.