Sub-study #14 - CCR Clinical Trials at NIH - Join Our Mailing List/Update Your Profile Business Contact Information

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Sub-study #14 - CCR Clinical Trials at NIH - Join Our Mailing List/Update Your Profile Business Contact Information Form and Instruction
1 Join CCR Mailing List #14_Attach 1_Join Our Mailing List.doc Form and Instruction
2 Update CCR Mailing List #14_Attach 2_Update Your Profile.doc Form and Instruction
#14_Request_CCR_06_20_12.doc Request for CCR Mailing List IC Document

Information Collection (IC) Details

IC Title:	Sub-study #14 - CCR Clinical Trials at NIH - Join Our Mailing List/Update Your Profile Business Contact Information	Agency IC Tracking Number:

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	1	Join CCR Mailing List	#14_Attach 1_Join Our Mailing List.doc		Yes	Yes	Fillable Fileable
Form and Instruction	2	Update CCR Mailing List	#14_Attach 2_Update Your Profile.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: SORN #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: 1,600	Number of Respondents for Small Entity: 1,600

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	1,600	0	0	0	0	0
Annual IC Time Burden (Hours)	133	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Request for CCR Mailing List	#14_Request_CCR_06_20_12.doc	06/20/2012

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