Household Enumeration

The Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)(NHLBI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0584 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Household Enumeration Form and Instruction
1 Personal Identifiers Personal Identifiers_07-13-07.doc Form and Instruction
2 Screen and Roster Screen and Roster_07-30-07.doc Form and Instruction

Information Collection (IC) Details

IC Title:	Household Enumeration	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	Personal Identifiers	Personal Identifiers_07-13-07.doc		Yes	Yes	Paper Only
Form and Instruction	2	Screen and Roster	Screen and Roster_07-30-07.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,191	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4,191	4,191
Annual IC Time Burden (Hours)	712	712
Annual IC Cost Burden (Dollars)	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.