Information Collection

Financial Sustainability of Human Tissue Biobanking Survey

IC 207898 under ICR 201307-0925-005 · OMB 0925-0679.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Financial Sustainability of Human Tissue Biobanking Survey	Form and Instruction
1 Biobanking Survey Attach1-Questionnaire Screen Shots-2.docx biobank-survey.healthcit.com	Form and Instruction
Attach3-List_survey_questions.docx Attach3-List_survey_questions	IC Document

IC Title:

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	1	Biobanking Survey	Attach1-Questionnaire Screen Shots-2.docx	HTTP://biobank-survey.healthcit.com	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 548

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	548	548
Annual IC Time Burden (Hours)	822	822
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attach3-List_survey_questions	Attach3-List_survey_questions.docx	07/22/2013

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