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Understanding Economic Risk for Low Income Families Survey
Prevention Communication Formative Research
OMB: 0990-0281
IC ID: 250514
OMB.report
HHS/HHSDM
OMB 0990-0281
ICR 202407-0990-002
IC 250514
( )
Documents and Forms
Document Name
Document Type
Attachment A_Economic Risk Study Instrument 11-15-21.docx
Other-
0990-0281 Generic economic risk 11-16-21.docx
Pilot Study for Understanding Economic Risk for Low Income Families Survey - Supporting Statement - Secion A
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Understanding Economic Risk for Low Income Families Survey
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
Other-
Attachment A_Economic Risk Study Instrument 11-15-21.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
200
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
200
0
0
0
0
200
Annual IC Time Burden (Hours)
67
0
0
0
0
67
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Pilot Study for Understanding Economic Risk for Low Income Families Survey - Supporting Statement - Secion A
0990-0281 Generic economic risk 11-16-21.docx
11/23/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
