Information Collection

Questionnaire For Study Of Morbidity In Childhood Cancer Survivors And Offspring

IC 111321 under ICR 197909-0925-004 · OMB 0925-0108.

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IC Title:

QUESTIONNAIRE FOR STUDY OF MORBIDITY IN CHILDHOOD CANCER SURVIVORS AND OFFSPRING

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,474

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	6,474	6,474
Annual IC Time Burden (Hours)	3,237	3,237
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Title	Document	Date Uploaded

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