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Cognitive Testing of 2025 NSCH Questionnaire – EPA Items addendum
Generic Clearance for Questionnaire Pretesting Research
OMB: 0607-0725
IC ID: 263351
OMB.report
DOC/CENSUS
OMB 0607-0725
ICR 202508-0607-002
IC 263351
( )
Documents and Forms
Document Name
Document Type
Form 1
Cognitive Testing of 2025 NSCH Questionnaire – EPA Items addendum
Form and Instruction
1 Protocol
2025 NSCH EPA Items Cognitive Interviewing Protocol_OMB.docx
Form and Instruction
2025 NSCH EPA Items Cognitive Interviewing OMB Letter.docx
OMB Memo
IC Document
2025 NSCH EPA Items Cognitive Interviewing Consent Form2_OMB.docx
Consent Form
IC Document
2025 NSCH EPA Items Cognitive Interviewing Participant Screener_OMB_Updated 10262023.docx
Screener Updated
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Cognitive Testing of 2025 NSCH Questionnaire – EPA Items addendum
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
Protocol
2025 NSCH EPA Items Cognitive Interviewing Protocol_OMB.docx
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
1
0
0
0
0
1
Annual IC Time Burden (Hours)
0
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo
2025 NSCH EPA Items Cognitive Interviewing OMB Letter.docx
11/13/2023
Consent Form
2025 NSCH EPA Items Cognitive Interviewing Consent Form2_OMB.docx
11/13/2023
Screener Updated
2025 NSCH EPA Items Cognitive Interviewing Participant Screener_OMB_Updated 10262023.docx
11/13/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.