Information Collection

Paper Survey for Early Independence Principal Investigator

IC 204296 under ICR 201308-0925-004 · OMB 0925-0665.

Documents and Forms

Document Name Document Type
Form Attachment A4 Paper Survey for Early Independence Principal Investigator Form and Instruction
Attachment A4 Paper Survey for EI-PI Attachment A.4 - Paper Survey for Early Independence Principal Investigators.doc Form and Instruction
Attachment B.3 - Protocol for Paper Survey EIA Principal Investigators.doc Protocols for Paper Survey IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Paper Survey for Early Independence Principal Investigator	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachment A4	Paper Survey for EI-PI	Attachment A.4 - Paper Survey for Early Independence Principal Investigators.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	24	12	12
Annual IC Time Burden (Hours)	12	6	6
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Protocols for Paper Survey	Attachment B.3 - Protocol for Paper Survey EIA Principal Investigators.doc	09/26/2012

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