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PATH/Baseline- Adults-Followup/Tracking Participant Information Form
Population Assessment of Tobacco and Health (PATH) Study (NIDA)
OMB: 0925-0664
IC ID: 203760
OMB.report
HHS/NIH
OMB 0925-0664
ICR 201208-0925-002
IC 203760
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0664 can be found here:
2016-07-05 - Revision of a currently approved collection
2015-10-07 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2f
PATH/Baseline- Adults-Followup/Tracking Participant Information Form
Form
2f Adult-Followup/Tracking/Baseline
2f. Followup_Tracking_Participant_Info_Form.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
PATH/Baseline- Adults-Followup/Tracking Participant Information Form
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
2f
Adult-Followup/Tracking/Baseline
2f. Followup_Tracking_Participant_Info_Form.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
NIH Privacy Act System of Records 09-25-0200 Clinical, Basic Population-based research studies of NIH, HHS/NIH/OD
FR Citation:
67 FR 60741
Number of Respondents:
42,730
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
85,460
0
85,460
0
0
0
Annual IC Time Burden (Hours)
8,546
0
8,546
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.