Information Collection

Number of Completes - Pretests

IC 202840 under ICR 201206-0910-009 · OMB 0910-0724.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0724 can be found here:

Documents and Forms

Document Name Document Type
APPENDIX 2_questionnaire_updated.doc Other-Appendix 2

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Number of Completes - Pretests	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 21 CFR 202.1(e)(6)(i)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix 2			APPENDIX 2_questionnaire_updated.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 900	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	900	900
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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