Cognitive Interviewing for Race and Ethnicity Interagency Technical Working Group (R/E ITWG): SAMHSA Study

Generic Clearance for Questionnaire Pretesting Research

Documents and Forms

Document Name Document Type
Form 1 Cognitive Interviewing for Race and Ethnicity Interagency Technical Working Group (R/E ITWG): SAMHSA Study Form and Instruction
1 Recruitment Email Text Attachment A Recruitment Email Text 040323_mc.docx Form and Instruction
OMB generic clearance request - ITWG race test interviews with SAMHSA -4.3.23_mc.docx OMB Letter IC Document
Attachment B Race And Ethnicity ITWG Testing Protocol-2_mc.docx Protocol IC Document
Spanish version OMB clearance request_revised 040623.docx Spanish Versions of Attachments A and B IC Document

Information Collection (IC) Details

IC Title:	Cognitive Interviewing for Race and Ethnicity Interagency Technical Working Group (R/E ITWG): SAMHSA Study	Agency IC Tracking Number:

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	Recruitment Email Text	Attachment A Recruitment Email Text 040323_mc.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 14	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	14	14
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Letter	OMB generic clearance request - ITWG race test interviews with SAMHSA -4.3.23_mc.docx	04/12/2023
Protocol	Attachment B Race And Ethnicity ITWG Testing Protocol-2_mc.docx	04/12/2023
Spanish Versions of Attachments A and B	Spanish version OMB clearance request_revised 040623.docx	04/12/2023

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