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Epidemiological Research Request -- Private Entities

IC 183743 under ICR 201308-0960-013 · OMB 0960-0701.

Documents and Forms
Document Name
Document Type
Other-Internet Screens
IC Document
Information Collection (IC) Details

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Epidemiological Research Request -- Private Entities
 
No Modified
 
Voluntary
 
20 CFR 401.165

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Internet Screens Current Epidemiological Research Review Information Application and Confidentiality Agreement.pdf http://www.ssa.gov/policy/about/epidemiology.html Yes Yes Fillable Fileable Signable

General Science and Innovation Scientific and Technological Research and Innovation

 

10 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10 0 0 -3 0 13
Annual IC Time Burden (Hours) 20 0 0 -6 0 26
Annual IC Cost Burden (Dollars) 35,000 0 0 -12,645 0 47,645

Title Document Date Uploaded
Previously Approved Epidemiological Research Review Internet Screens Previously Approved Epidemiological Research Review Information, Application and Confidentiality Agreement.pdf 10/23/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.