View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Bundled Sub-studies #14, #15, #16 (#14 WYNTK, #15 Accrual CT, #16 CIRB Pilot)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 14 Yes No Paper Only
Form and Instruction 15 Yes Yes Fillable Fileable
Form and Instruction 16 Yes Yes Fillable Fileable

Health Consumer Health and Safety

SORN #09-25-0156 "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD."  67 FR 60743

3,322 0
   
Individuals or Households
 
   97 %

  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 3,322 0 0 0 0 0
Annual IC Time Burden (Hours) 644 0 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Memo to OMB_Key To Bundle #14 15 16 05/12/2011
Bundle Gen IC Form_14-15-16-WYNTK_Accrual_CIRB Pilot 05/12/2011
#14_Justif Memo & Attach 14C 14D_WYNTK 05/12/2011
#15_Justif Memo_Accrual CT_CTEP 05/12/2011
#16_Justif Memo Attach 16A Consent_CIRB 05/12/2011
NCI response to questions 06/15/2011
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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