Participants Follow-up Year 2

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⚠️ Notice: This information collection may be referencing outdated material.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 2 Participants Follow-up Year 2 Form and Instruction
2 Interview Interview Form Contact Yr2_English.doc Form and Instruction
1 Food Propensity Food Propensity Qx English.docm Form

Information Collection (IC) Details

IC Title:	Participants Follow-up Year 2	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	2	Interview	Interview Form Contact Yr2_English.doc		Yes	Yes	Fillable Fileable
Form	1	Food Propensity	Food Propensity Qx English.docm		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,333	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,333	1,142	4,191
Annual IC Time Burden (Hours)	1,333	621	712
Annual IC Cost Burden (Dollars)	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.