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Abstraction Form for Physicians (CEERCC)
Follow-up of Kidney Cancer Patients from the Central European Multicenter Case-Control Study (CEERCC) (NCI)
OMB: 0925-0599
IC ID: 187789
OMB.report
HHS/NIH
OMB 0925-0599
ICR 200901-0925-004
IC 187789
( )
Documents and Forms
Document Name
Document Type
Form 2
Abstraction Form for Physicians (CEERCC)
Form
2 Abstraction
Attach 7_Abstraction.Form.w.burden.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Abstraction Form for Physicians (CEERCC)
Agency IC Tracking Number:
Is this a Common Form?
No
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
2
Abstraction
Attach 7_Abstraction.Form.w.burden.docx
No
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
10
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
10
0
10
0
0
0
Annual IC Time Burden (Hours)
3
0
3
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.