Information Collection

Key Influencer Survey Instrument - Time 1

IC 191221 under ICR 200911-0925-002 · OMB 0925-0611.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Survey Key Influencer Survey Instrument - Time 1	Form and Instruction
1 Survey Attachment C InfluencerSurvey_1-20-10.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form?

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1				No		Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 656

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	656	656
Annual IC Time Burden (Hours)	216	216
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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