Information Collection

Asthma Research Survey

IC 183322 under ICR 200801-0925-003 · OMB 0925-0588.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Asthma Research Survey	Form and Instruction
1 Asthma Research Survey OMB Attachment 1 Survey.doc	Form and Instruction
OMB Attachment 2 Introductory and Follow-up Letters.doc OMB Attachment 2 Introductory and Follow-up Letters	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	Asthma Research Survey	OMB Attachment 1 Survey.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,550

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

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	1,550	1,550
Annual IC Time Burden (Hours)	388	388
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Attachment 2 Introductory and Follow-up Letters	OMB Attachment 2 Introductory and Follow-up Letters.doc	12/03/2007

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