OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Defferal Questionnaire

IC 193150 under ICR 201006-0925-002 · OMB 0925-0620.

Documents and Forms
Document Name
Document Type
Other- Deferral Study Consent Form P
Other- Deferral study Questionnaire
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Defferal Questionnaire
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other- Deferral Study Consent Form Portuguese Deferral Study Consent Form Portuguese.doc Yes Yes Paper Only
Other- Deferral study Questionnaire Portuguese Deferral study Questionnaire Portuguese.rtf Yes Yes Paper Only

Health Public Health Monitoring

 

4,860 0
   
Individuals or Households
 
   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 4,860 0 4,860 0 0 0
Annual IC Time Burden (Hours) 1,604 0 1,604 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment 7_Deferral Informed consent Attachment 7_Deferral Informed consent.doc 02/25/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.