Information Collection

On-line Survey for Early Indepenedence Principal Investigators

IC 204293 under ICR 201308-0925-004 · OMB 0925-0665.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment 6 On-line Survey for Early Indepenedence Principal Investigators	Form and Instruction
Attachment 6 Screenshots of EIA PI Survey Screenshots Online survey EIA Principal Investigators (versions AB).pdf	Form and Instruction
Attachment B.2.1 - Protocols Online Survey EIA Principal Investigator.doc On-line Survey Protocols	IC Document
Attachment 6 Proposed Final Online Survey EIA Principal Investigators (Versions A B).doc Attachment 6: Word version of the EIA PI Online Survey - final version	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	Attachment 6	Screenshots of EIA PI Survey	Screenshots Online survey EIA Principal Investigators (versions AB).pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	40	16	24
Annual IC Time Burden (Hours)	30	6	24
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
On-line Survey Protocols	Attachment B.2.1 - Protocols Online Survey EIA Principal Investigator.doc	09/26/2012
Attachment 6: Word version of the EIA PI Online Survey - final version	Attachment 6 Proposed Final Online Survey EIA Principal Investigators (Versions A B).doc	08/16/2013

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