Information Collection

Online Survey for Point of Contact of Host Institutions

IC 204299 under ICR 201209-0925-003 · OMB 0925-0665.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0665 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment A8.1 Online Survey for Point of Contact of Host Institutions	Form and Instruction
Attachment A8.1 Screenshots for Online survey for POCs @Host Institution Attachment A.8.1 - Screenshots Online Survey Point of Contact Host Institution.pdf	Form and Instruction
Attachment A.8 - Online Survey Point of Contact Host Institution.doc Attachment A8 Online Survey for POCs @ Host Institutes (Paper Version)	IC Document
Attachment B.2.2 - Protocols Online Survey POC Host Institution.doc On-line Survey Protocols	IC Document

IC Title:

Online Survey for Point of Contact of Host Institutions

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
Form and Instruction	Attachment A8.1	Screenshots for Online survey for POCs @Host Institutions	Attachment A.8.1 - Screenshots Online Survey Point of Contact Host Institution.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 24

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	24	24
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment A8 Online Survey for POCs @ Host Institutes (Paper Version)	Attachment A.8 - Online Survey Point of Contact Host Institution.doc	09/17/2012
On-line Survey Protocols	Attachment B.2.2 - Protocols Online Survey POC Host Institution.doc	09/26/2012

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