Information Collection

IECRN Core Survey-PI

IC 7474 under ICR 200807-0925-001 · OMB 0925-0550.

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	IECRN Core Survey-PI	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

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: 20	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	Previously Approved
Annual Number of Responses for this IC	20	-255	275
Annual IC Time Burden (Hours)	5	-701	706
Annual IC Cost Burden (Dollars)	0	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.