Refusal Reasons and Demographics for FORCS

Food Reporting Comparison Study (FORCS) and Food and Eating Assessment Study (FEAST) (NCI)

Documents and Forms

Document Name Document Type
Form 12 Refusal Reasons and Demographics for FORCS Form and Instruction
12 Att. 4A_Refusal Reasons and Demographics Attach 4 - FORCS screen shots 11-0330.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Refusal Reasons and Demographics for FORCS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	12	Att. 4A_Refusal Reasons and Demographics	Attach 4 - FORCS screen shots 11-0330.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: 09-25-0156, "Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD"	FR Citation: 67 FR 60743

Number of Respondents: 1,770	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,770	1,770
Annual IC Time Burden (Hours)	148	148
Annual IC Cost Burden (Dollars)	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.