Adult Diet Survey Instrument (Attachment J)

The Family Life, Activity, Sun, Health, and Eating Study (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0686 can be found here:

Documents and Forms

Document Name Document Type
Form 6 Adult Diet Survey Instrument (Attachment J) Form
6 Adult Diet Survey Intrument (Attachment J) Attach J - Adult Diet Instrument.docx https:/www.research-survey.org/efm/wsb.dll/s/1g3c Form

Information Collection (IC) Details

IC Title:	Adult Diet Survey Instrument (Attachment J)	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	6	Adult Diet Survey Intrument (Attachment J)	Attach J - Adult Diet Instrument.docx	https:/www.research-survey.org/efm/wsb.dll/s/1g3c	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: Clinical, Basic, Population-based Research Studies of the National Institutes of Health	FR Citation: 67 FR 60776

Number of Respondents: 1,250	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
Annual Number of Responses for this IC	1,250	1,250
Annual IC Time Burden (Hours)	313	313
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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