IECRN Core Survey-PI/Network Contact

Inventory and Evaluation of Clinical Research Networks (NCRR)

Documents and Forms

Document Name Document Type
Form 1 IECRN Core Survey-PI/Network Contact Form
1 Survey Attachment 2_Core Survey_20060817 FORM.pdf Form

Information Collection (IC) Details

IC Title:	IECRN Core Survey-PI/Network Contact	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Survey	Attachment 2_Core Survey_20060817 FORM.pdf		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 280	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 98 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	280	280
Annual IC Time Burden (Hours)	47	47
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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