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Web Re-Entry iCLIC
interactive Comprehensive Lifestyle Interview by Computer (iCLIC) Study (NCI)
OMB: 0925-0594
IC ID: 186347
OMB.report
HHS/NIH
OMB 0925-0594
ICR 200904-0925-001
IC 186347
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0594 can be found here:
2010-12-27 - Extension without change of a currently approved collection
2009-12-07 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 8
Web Re-Entry iCLIC
Form
8 Web Re-Entry
Att 8_Re-Entry Screenshots.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Web Re-Entry iCLIC
Agency IC Tracking Number:
Is this a Common Form?
No
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
8
Web Re-Entry
Att 8_Re-Entry Screenshots.doc
Yes
Yes
Fillable Fileable
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:
1,716
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
10,296
0
0
8,536
0
1,760
Annual IC Time Burden (Hours)
858
0
0
711
0
147
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.