Information Collection

Participant Verification & Tracing Interview

IC 202209 under ICR 201401-0925-004 · OMB 0925-0593.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0593 can be found here:

Documents and Forms

Document Name Document Type
Form 21.1 Participant Verification & Tracing Interview Form and Instruction
21.1 Survey ParticipantVerificationTracingQuestionnaire.docx Form and Instruction
PVTContactVerificationForm.docx PVTContactVerificationForm IC Document
PVTKeyDataVerificationForm.docx PVTKeyDataVerificationForm IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Participant Verification & Tracing Interview	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	21.1	Survey	ParticipantVerificationTracingQuestionnaire.docx		Yes	Yes	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 877	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	13,155	10,835	2,320
Annual IC Time Burden (Hours)	1,535	1,342	193
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
PVTContactVerificationForm	PVTContactVerificationForm.docx	11/08/2013
PVTKeyDataVerificationForm	PVTKeyDataVerificationForm.docx	11/08/2013

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