Information Collection

Researchers

IC 204858 under ICR 201211-0925-008 · OMB 0925-0666.

Documents and Forms

Document Name Document Type
Form 1 Researchers Form and Instruction
1 Survey Attachment 2_SGI survey_screenshots_v2.docx Form and Instruction
Attachment 1_SGI-SurveyQuestions_v2.docx Attachment 1_SGI-SurveyQuestions_v2 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Researchers	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 and Instruction	1	Survey	Attachment 2_SGI survey_screenshots_v2.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment 1_SGI-SurveyQuestions_v2	Attachment 1_SGI-SurveyQuestions_v2.docx	11/13/2012

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