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Questionnaire For Next-of-kin In An Epidemiologic Case-control Study Of Soft-tissue Sarcoma, Hodgkin's Disease, And Non-hodgkin's Lymphmaoma In Kansas

IC 111427 under ICR 198207-0925-002 · OMB 0925-0182.

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IC Title:

QUESTIONNAIRE FOR NEXT-OF-KIN IN AN EPIDEMIOLOGIC CASE-CONTROL STUDY OF SOFT-TISSUE SARCOMA, HODGKIN'S DISEASE, AND NON-HODGKIN'S LYMPHMAOMA IN KANSAS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

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Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Federal Enterprise Architecture Business Reference Module

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 480

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	480	480
Annual IC Time Burden (Hours)	240	240
Annual IC Cost Burden (Dollars)	0	0

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