Information Collection

Colorectal Cancer Population Survey

IC 208027 under ICR 201308-0920-003 · OMB 0920-0992.

Documents and Forms

Document Name Document Type
Colorectal Cancer Population Survey Form
Colorectal Cancer Population Survey ATT 4A Colorectal Cancer Population Survey_7.18.2013.docx Form
ATT 4B Screen shots of the CATI Administration Population Survey.pdf Att 4b - Screenshots IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Colorectal Cancer Population Survey	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	none	Colorectal Cancer Population Survey	ATT 4A Colorectal Cancer Population Survey_7.18.2013.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title: Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 3,200	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	3,200	3,200
Annual IC Time Burden (Hours)	1,227	1,227
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Att 4b - Screenshots	ATT 4B Screen shots of the CATI Administration Population Survey.pdf	07/29/2013

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