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GenIC for CCQDER's RANDS 9
[NCHS] Collaborating Center for Questionnaire Design and Evaluation Research
OMB: 0920-0222
IC ID: 262818
OMB.report
HHS/CDC
OMB 0920-0222
ICR 202504-0920-019
IC 262818
( )
Documents and Forms
Document Name
Document Type
Form 1
GenIC for CCQDER's RANDS 9
Form and Instruction
1 qustionnaire
Attachment 1 - RANDS 9 Questionnaire_FINAL 11 02 2023.docx
Form and Instruction
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9.docx
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9
IC Document
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9.docx
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9
IC Document
Attachment 4 – Comparison of Topics between RANDS 8 & 9.docx
Attachment 4 – Comparison of Topics between RANDS 8 & 9
IC Document
SSB-RANDS 9_9.24.23.docx
SSB
IC Document
SSA-RANDS 9_REVISED_11 02 2023_FINAL_amb.docx
SSA for RANDS 9
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
GenIC for CCQDER's RANDS 9
Agency IC Tracking Number:
0920-0222-23IG
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
1
qustionnaire
Attachment 1 - RANDS 9 Questionnaire_FINAL 11 02 2023.docx
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:
49,800
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
49,800
0
0
0
0
49,800
Annual IC Time Burden (Hours)
12,450
0
0
0
0
12,450
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9
Attachment 2 - NCHS Non-Disclosure Affidavit for NORC_RANDS 9.docx
10/16/2023
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9
Attachment 3 - NORC CIPESA Protection Plan_RANDS 9.docx
10/16/2023
Attachment 4 – Comparison of Topics between RANDS 8 & 9
Attachment 4 – Comparison of Topics between RANDS 8 & 9.docx
10/16/2023
SSB
SSB-RANDS 9_9.24.23.docx
10/16/2023
SSA for RANDS 9
SSA-RANDS 9_REVISED_11 02 2023_FINAL_amb.docx
11/03/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.