View Information Collection (IC)
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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Fellows' Cancer Health Disparities Interest Group (CHDIG) Survey (NCI)
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
1
CHDIG survey
CHDIG Fellows Survey.pdf
Yes
Yes
Fillable Fileable
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:
180
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
180
0
180
0
0
0
Annual IC Time Burden (Hours)
30
0
30
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
fast track survey for CHDIG
Fast Track -Fellows Survey CHDIG_2022 FINAL.docx
01/25/2022
email invite
Email invite (2).docx
01/25/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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The .gov means it's official.
The site is secure.
