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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Information Collection (IC) Details

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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:

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 %

	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

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