Information Collection

Assessing Progress Toward the Goals of the National Cancer Institute's Provocative Questions Initiative

IC 219843 under ICR 201304-0925-003 · OMB 0925-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Assessing Progress Toward the Goals of the National Cancer Institute's Provocative Questions Initiative Form and Instruction
1 Attachment A Funded Applicants Survey Consent Form ATTACHMENT A - Funded Applicants Survey Consent Form.docx Form and Instruction
2 Attachment B Funded Applicants Survey Screen Shots ATTACHMENT B - Funded Applicants Survey Screen Shots.docx Form and Instruction
3 Attachment C Unfunded Applicants Survey Consent Form ATTACHMENT C - Unfunded Applicants Survey Consent Form.docx Form and Instruction
4 Attachment D Unfunded Applicants Survey Screenshot ATTACHMENT D - Unfunded Applicants Survey Screenshots.docx Form and Instruction
5 Attachment F Interview/Protocol-Workshop Participants ATTACHMENT F Interview Protocol-Workshop Participants.docx Form and Instruction
6 Attachment G Interview Protocol-Grant Reviewer ATTACHMENT G Interview Protocol- Grant Reviewer.docx Form and Instruction
Mini SSA PQ 1.15.2016.docx Mini SSA IC Document
ATTACHMENT E Email correspondence to Funded and Unfunded Applicants.docx Attachment E Email correspondence to Funded and Unfunded Applicants IC Document
ATTACHMENT H Email Correspondence to Grant Reviewers and Workshop Partic....docx Attachment H Email Correspondence to Grant Reviewers and Workshop Participants IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assessing Progress Toward the Goals of the National Cancer Institute's Provocative Questions Initiative	Agency IC Tracking Number:

IC Status: New

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	1	Attachment A Funded Applicants Survey Consent Form	ATTACHMENT A - Funded Applicants Survey Consent Form.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2	Attachment B Funded Applicants Survey Screen Shots	ATTACHMENT B - Funded Applicants Survey Screen Shots.docx	Yes	Yes	Fillable Fileable
Form and Instruction	3	Attachment C Unfunded Applicants Survey Consent Form	ATTACHMENT C - Unfunded Applicants Survey Consent Form.docx	Yes	Yes	Fillable Fileable
Form and Instruction	4	Attachment D Unfunded Applicants Survey Screenshot	ATTACHMENT D - Unfunded Applicants Survey Screenshots.docx	Yes	Yes	Fillable Fileable
Form and Instruction	5	Attachment F Interview/Protocol-Workshop Participants	ATTACHMENT F Interview Protocol-Workshop Participants.docx	Yes	Yes	Fillable Fileable
Form and Instruction	6	Attachment G Interview Protocol-Grant Reviewer	ATTACHMENT G Interview Protocol- Grant Reviewer.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,738	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,738	1,738
Annual IC Time Burden (Hours)	307	307
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Mini SSA	Mini SSA PQ 1.15.2016.docx	01/27/2016
Attachment E Email correspondence to Funded and Unfunded Applicants	ATTACHMENT E Email correspondence to Funded and Unfunded Applicants.docx	01/27/2016
Attachment H Email Correspondence to Grant Reviewers and Workshop Participants	ATTACHMENT H Email Correspondence to Grant Reviewers and Workshop Partic....docx	01/27/2016

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