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PATH/Baseline- Adults-Followup/Tracking Participant Information Form

IC 203760 under ICR 201312-0925-006 · OMB 0925-0664.

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Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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PATH/Baseline- Adults-Followup/Tracking Participant Information Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Follow-up/Tracking Participant Information Form 3f - English. Followup Tracking participant Information Form 050813.pdf Yes Yes Fillable Fileable
Form and Instruction 1 Revised Adult Tracking Information Form FRT2 Adult Participant Information Form REVISED 121313.doc Yes Yes Fillable Fileable

Health Immunization Management

NIH Privacy Act System of Records 09-25-0200 Clinical, Basic Population-based research studies of NIH, HHS/NIH/OD  67 FR 60741

42,730 0
   
Individuals or Households
 
   0 %

  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 85,460 0 0 0 0 85,460
Annual IC Time Burden (Hours) 11,395 0 0 0 0 11,395
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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