Household Roster--Main: Baseline & Follow-up 2 Replenishment

The Real Cost Campaign Outcomes Evaluation Study: Cohort 3 (Outcomes Study)

OMB: 0910-0915

IC ID: 257639

Documents and Forms
Document Name
Document Type
Other-ENGLISH Parent Guardian Mail S
Other-ENGLISH Parent Guardian Mail S
Other-SPANISH Parent Guardian Mail S
Other-SPANISH Parent Guardian Mail S
Information Collection (IC) Details

View Information Collection (IC)

Household Roster--Main: Baseline & Follow-up 2 Replenishment
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-ENGLISH Parent Guardian Mail Screener Attachment 1. Parent Guardian Mail Screener.docx No   Paper Only
Other-SPANISH Parent Guardian Mail Screener Attachment 1. Parent Guardian Mail Screener_rev_SPA_FINAL.docx No   Paper Only

Health Consumer Health and Safety

 

5,500 0
   
Individuals or Households
 
   99 %

  Approved 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 5,500 0 0 0 0 5,500
Annual IC Time Burden (Hours) 440 0 0 0 0 440
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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