Annual Recontact Questionaire

Gulf Long-Term Follow-Up Study for Oil Spill Clean-Up Workers and Volunteers (NIEHS)

Documents and Forms

Document Name Document Type
Form 1 Annual Recontact Questionaire Form and Instruction
1 Annual Recontact Questionaire Att_09 Annual Recontact Screens_20131206.pdf Form and Instruction
Att_08 Annual Recontact Request Letter.pdf Att_08 Annual Recontact Request Letter IC Document

Information Collection (IC) Details

IC Title:	Annual Recontact Questionaire	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	1	Annual Recontact Questionaire	Att_09 Annual Recontact Screens_20131206.pdf		Yes	Yes	Fillable Fileable

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: 32,762	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	98,286	43,286	55,000
Annual IC Time Burden (Hours)	24,572	-27,428	52,000
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Att_08 Annual Recontact Request Letter	Att_08 Annual Recontact Request Letter.pdf	01/29/2014

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