CANCER INFORMATION SERVICE CALL RECORD FORM

ICR 198305-0925-004

OMB: 0925-0208

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
111467
Migrated
ICR Details
0925-0208 198305-0925-004
Historical Active
HHS/NIH
CANCER INFORMATION SERVICE CALL RECORD FORM
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 07/08/1983
Retrieve Notice of Action (NOA) 05/20/1983
  Inventory as of this Action Requested Previously Approved
11/30/1984 11/30/1984
267,120 0 0
2,136 0 0
0 0 0

THE CANCER INFORMATION SERVICE PROVIDES THE GENERAL PUBLIC, CANCER PATIENTS AND FAMILIES, AND HEALTH PROFESSIONALS WITH THE LATEST INFORMATION ON CANCER. THE FIELD EVALUATION INVOLVES ASKING CIS USERS SEVEN QUESTIONS, INCLUDING FIVE DEMOGRAPHICS. THE RESULTING INFORMATION IS USED TO MONITOR PROGRAM PROGRESS.

None
None


No

1
IC Title Form No. Form Name
CANCER INFORMATION SERVICE CALL RECORD FORM

  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 267,120 0 0 267,120 0 0
Annual Time Burden (Hours) 2,136 0 0 2,136 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
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.
05/20/1983


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