View Information Collection (IC)

View Information Collection (IC)

IC Title:	User Satisfaction Survey for Principal Investigators of Other Screening/Probe Production Centers	Agency IC Tracking Number:

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	survey	NLM Survey Instrument.rtf		Yes	Yes	Paper Only
Form and Instruction	2	revised survey	Revised Survey NLM.rtf		Yes	Yes	Paper Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 45	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	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	45	0	45	0	0	0
Annual IC Time Burden (Hours)	5	0	5	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
NLM GC Form	NLM GC Form.docx	02/12/2009
NLM Mini-Supporting Statement	NLM Mini-Supporting Statement.docx	02/12/2009
Terms of Clearance	Terms of Clearance.pdf	02/26/2009

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