Attachment 25: Paper/pen, CAWI or CATI Instruments for Private Applicators for AHS

Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Diseases Among Men and Women in Agriculture (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0406 can be found here:

Documents and Forms

Document Name Document Type
Form 7 Attachment 25: Paper/pen, CAWI or CATI Instruments for Private Applicators for AHS Form and Instruction
7 CATI Attachment 25-2_CATI_Ppt_Intro.doc Form and Instruction
6 Paper/pen, CAWI or CATI Attachment 25-1_CAWI_Ppt_Intro.docx Form and Instruction
9 Paper and Pencil Attachment 25-4_Ppt_PaperPenSurvey.docx Form and Instruction
8 CAWI-CATI Attachment 25-3_CAWI_CATI_Ppt_Survey_Partial.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Attachment 25: Paper/pen, CAWI or CATI Instruments for Private Applicators for AHS	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	7	CATI	Attachment 25-2_CATI_Ppt_Intro.doc	No	No	Printable Only
Form and Instruction	6	Paper/pen, CAWI or CATI	Attachment 25-1_CAWI_Ppt_Intro.docx	Yes	Yes	Fillable Printable
Form and Instruction	9	Paper and Pencil	Attachment 25-4_Ppt_PaperPenSurvey.docx	No	No	Printable Only
Form and Instruction	8	CAWI-CATI	Attachment 25-3_CAWI_CATI_Ppt_Survey_Partial.docx	Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: SORN #09-25-0200, Clinical, Epidemiologic, and Biometric Studies of the National Institutes of Health (NIH), HHS/NIH/ OD	FR Citation: 67 FR 60776

Number of Respondents: 13,855	Number of Respondents for Small Entity: 13,855

Affected Public: Private Sector	Private Sector: Farms

Percentage of Respondents Reporting Electronically: 33 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	13,855	13,705	150
Annual IC Time Burden (Hours)	5,773	5,685	88
Annual IC Cost Burden (Dollars)	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.