Information Collection

#3, #4, and #5 Bundled Sub-studies for Website Evaluations - Science of Team Science, SEER and Epi Genetics Research Programs

IC 193888 under ICR 200802-0925-005 · OMB 0925-0589.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0589 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 #3, #4, and #5 Bundled Sub-studies for Website Evaluations - Science of Team Science, SEER and Epi Genetics Research Programs	Form and Instruction
1 #3 Attachments A1 and A4 #3_Attach A1 & A4_Profile Qx. & Interview Guide_TS Toolkit.doc	Form and Instruction
2 #4 Attachments B2, B5, B6 & B7 #4_Attach B2,B5,B6&B7_SEER.PDF	Form and Instruction
3 #5 Attachments C2, C3, C4 & C5 #5 Attach C2, C3, C4, & C5_EGRP Web Testing.doc	Form and Instruction
Memo to OMB_Key To Bundled Pkg.doc Memo to OMB_Key To Bundled Pkg	IC Document
Combined Generic Sub-study Form_0925-0589-#3 STS, #4 SEER, #5 EGPR.doc Combined Generic Sub-study Form_0925-0589-#3 STS, #4 SEER, #5 EGPR	IC Document
#3_Justif Memo & Attach A2 & A3_TS Toolkit_rev3.doc #3_Justif Memo & Attach A2 & A3_TS Toolkit_rev3	IC Document
#4_Justif Memo & Attach B1, B3, B4 & B8_SEER_rev3.doc #4_Justif Memo & Attach B1, B3, B4 & B8_SEER_rev3	IC Document
#5 Justif Memo & Attach C1 & C6_EGRP Web Testing_rev2.doc #5 Justif Memo & Attach C1 & C6_EGRP Web Testing_rev2	IC Document
Combined Burden and Cost Table.pdf Combined Burden and Cost Table	IC Document

IC Title:

#3, #4, and #5 Bundled Sub-studies for Website Evaluations - Science of Team Science, SEER and Epi Genetics Research Programs

Agency IC Tracking Number:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	#3 Attachments A1 and A4	#3_Attach A1 & A4_Profile Qx. & Interview Guide_TS Toolkit.doc	Yes	No	Fillable Fileable
Form and Instruction	2	#4 Attachments B2, B5, B6 & B7	#4_Attach B2,B5,B6&B7_SEER.PDF	Yes	No	Fillable Fileable
Form and Instruction	3	#5 Attachments C2, C3, C4 & C5	#5 Attach C2, C3, C4, & C5_EGRP Web Testing.doc	Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"

FR Citation: 67 FR 60743

Number of Respondents: 293

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 25 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	293	0	0	0	0	0
Annual IC Time Burden (Hours)	110	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Memo to OMB_Key To Bundled Pkg	Memo to OMB_Key To Bundled Pkg.doc	07/13/2010
Combined Generic Sub-study Form_0925-0589-#3 STS, #4 SEER, #5 EGPR	Combined Generic Sub-study Form_0925-0589-#3 STS, #4 SEER, #5 EGPR.doc	07/13/2010
#3_Justif Memo & Attach A2 & A3_TS Toolkit_rev3	#3_Justif Memo & Attach A2 & A3_TS Toolkit_rev3.doc	07/13/2010
#4_Justif Memo & Attach B1, B3, B4 & B8_SEER_rev3	#4_Justif Memo & Attach B1, B3, B4 & B8_SEER_rev3.doc	07/13/2010
#5 Justif Memo & Attach C1 & C6_EGRP Web Testing_rev2	#5 Justif Memo & Attach C1 & C6_EGRP Web Testing_rev2.doc	07/13/2010
Combined Burden and Cost Table	Combined Burden and Cost Table.pdf	07/13/2010

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