Information Collection

Questionnaire For An Epidemiologic Case/control Study Of Bladder Cancer In New Hampshire And Vermont

IC 111366 under ICR 198105-0925-003 · OMB 0925-0138.

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IC Title:

QUESTIONNAIRE FOR AN EPIDEMIOLOGIC CASE/CONTROL STUDY OF BLADDER CANCER IN NEW HAMPSHIRE AND VERMONT

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: 1,350

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,350	1,350
Annual IC Time Burden (Hours)	675	675
Annual IC Cost Burden (Dollars)	0	0

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