Information Collection

Paper Survey for Early Independence Principal Investigator

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

Documents and Forms

Documents and forms in this information collection
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

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 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 %

table that charts list of burden
	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

table that charts IC Documents
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.