QUESTIONNAIRE FOR SOURCE DIRECTORY

ICR 197901-0925-003

OMB: 0925-0019

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
111212
Migrated
ICR Details
0925-0019 197901-0925-003
Historical Active 197712-0925-005
HHS/NIH
QUESTIONNAIRE FOR SOURCE DIRECTORY
Revision of a currently approved collection   No
Regular
Approved without change 01/09/1979
Retrieve Notice of Action (NOA) 01/03/1979
  Inventory as of this Action Requested Previously Approved
01/31/1980 01/31/1980 12/31/1978
50 0 50
50 0 50
0 0 0



None
None


No

1
IC Title Form No. Form Name
QUESTIONNAIRE FOR SOURCE DIRECTORY

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 50 50 0 0 0 0
Annual Time Burden (Hours) 50 50 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/03/1979


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