IIE-Informant Interview Deaths - Eng

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

Documents and Forms

Document Name Document Type
Form 1 IIE-Informant Interview Deaths - Eng Form and Instruction
1 IIE Informant Interview Deaths IIE-Informant interview_Eng-01-15-2014.pdf Form and Instruction
IIS-Informant interview_Spanish-01-15-2015.pdf IIS Informant Interview Deaths - Span IC Document

Information Collection (IC) Details

IC Title:	IIE-Informant Interview Deaths - Eng	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	IIE Informant Interview Deaths	IIE-Informant interview_Eng-01-15-2014.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 154	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	154	154
Annual IC Time Burden (Hours)	77	77
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
IIS Informant Interview Deaths - Span	IIS-Informant interview_Spanish-01-15-2015.pdf	06/27/2014

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