Information Collection

Full Survey

IC 203027 under ICR 201207-0910-002 · OMB 0910-0722.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
FDA Obesity - Survey Instrument Final.pdf	Other-Obesity Survey
FDA Obesity - Survey Screen Shots Final.pdf Survey Screen Shots	IC Document

IC Title:

Full Survey

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
Other-Obesity Survey			FDA Obesity - Survey Instrument Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 450

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	450	450
Annual IC Time Burden (Hours)	189	189
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Survey Screen Shots	FDA Obesity - Survey Screen Shots Final.pdf	06/21/2012

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