Information Collection

Application for Inclusion in NCI Cancer Genetics Services Directory (PDQ)(R)

IC 198117 under ICR 201106-0925-003 · OMB 0925-0639.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0639 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Application for Inclusion in NCI Cancer Genetics Services Directory (PDQ)(R)	Form
1 Application for Inclusion in NCI Cancer Genetics Service Attach 1_Application_CGDirectory.pdf	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Application for Inclusion in NCI Cancer Genetics Services Directory (PDQ)(R)

Agency IC Tracking Number:

Is this a Common Form? No

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	1	Application for Inclusion in NCI Cancer Genetics Services Directory (PDQ?)	Attach 1_Application_CGDirectory.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title: SORN 09-25-0156 "Records of Participants in Programs and Respondents in Survey Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIHOD"

FR Citation: 67 FR 60743

Number of Respondents: 60

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	30	30
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.