Information Collection

FSR 265 FTC Complaint Assistant, FSR 266 CFTC, FSR 267 HHS NIDCR, FSR 268 HHS NCI SEER, FSR 269 FDA

IC 190115 under ICR 201101-1090-002 · OMB 1090-0008.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0008 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FSR 265 FSR 265 FTC Complaint Assistant, FSR 266 CFTC, FSR 267 HHS NIDCR, FSR 268 HHS NCI SEER, FSR 269 FDA	Form
FSR 265 FTC Complaint Assistant questionnaire FSR 265 FTC ComplaintAssistant questionnaire.xls	Form
FSR 266 CFTC questionnaire FSR 266 CFTC questionnaire.xls	Form
FSR 267 HHS NIDCR Spanish questionnaire FSR 267 HHS NIDCR Spanish questionnaire.xls	Form
FSR 268 HHS NCI SEER questionnaire FSR 268 HHS NCI SEER questionnaire.xls	Form
FSR 269 HHS FDA questionnaire FSR 269 HHS FDA.xls	Form
Justification for ICs to generic ICR 1090-0008.doc Justification for ICs to generic ICR 1090-0008	IC Document

IC Title:

FSR 265 FTC Complaint Assistant, FSR 266 CFTC, FSR 267 HHS NIDCR, FSR 268 HHS NCI SEER, FSR 269 FDA

Agency IC Tracking Number:

FSR 265, FSR 266, FSR 267, FSR 268, FSR 269

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FSR 265	FTC Complaint Assistant questionnaire	FSR 265 FTC ComplaintAssistant questionnaire.xls	Yes	Yes	Fillable Fileable
Form	FSR 266	CFTC questionnaire	FSR 266 CFTC questionnaire.xls	Yes	Yes	Fillable Fileable
Form	FSR 267	HHS NIDCR Spanish questionnaire	FSR 267 HHS NIDCR Spanish questionnaire.xls	Yes	Yes	Fillable Fileable
Form	FSR 268	HHS NCI SEER questionnaire	FSR 268 HHS NCI SEER questionnaire.xls	Yes	Yes	Fillable Fileable
Form	FSR 269	HHS FDA questionnaire	FSR 269 HHS FDA.xls	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 25,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	25,000	25,000
Annual IC Time Burden (Hours)	1,042	1,042
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification for ICs to generic ICR 1090-0008	Justification for ICs to generic ICR 1090-0008.doc	07/29/2009

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.