Information Collection

Study Registration

IC 211028 under ICR 201403-0920-017 · OMB 0920-1018.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Study Registration	Form
Registration Study Registration_screenshot.docx	Form
Att 3b Study Registration.docx Registration	IC Document

IC Title:

Study Registration

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Registration	Study Registration_screenshot.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 14,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	14,000	14,000
Annual IC Time Burden (Hours)	1,167	1,167
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Registration	Att 3b Study Registration.docx	03/27/2014

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