Information Collection

SBIR Survey

IC 7420 under ICR 200711-0925-002 · OMB 0925-0499.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 SBIR Survey	Form and Instruction
1 SBIR C 1 Attachment 1 Data Collection Instrument.doc	Form and Instruction
2 Follow-up C 2 Attachment 2 Introductory and Follow-up Letters to Respondents3 1 Contact Update Email 120506.doc	Form and Instruction
C. 3 HumanSubjectsPDF.pdf C	IC Document
C 4 PrivacyActPDF.pdf C 4 PrivacyActPDF	IC Document

IC Title:

SBIR Survey

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Form and Instruction	1	SBIR	C 1 Attachment 1 Data Collection Instrument.doc		Yes	Yes	Paper Only
Form and Instruction	2	Follow-up	C 2 Attachment 2 Introductory and Follow-up Letters to Respondents3 1 Contact Update Email 120506.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 704

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	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	1,704	704	1,000
Annual IC Time Burden (Hours)	852	352	500
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
C	C. 3 HumanSubjectsPDF.pdf	10/04/2007
C 4 PrivacyActPDF	C 4 PrivacyActPDF.pdf	10/04/2007

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