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Adult Diet Survey Instrument (Attachment J)
The Family Life, Activity, Sun, Health, and Eating Study (NCI)
OMB: 0925-0686
IC ID: 208732
OMB.report
HHS/NIH
OMB 0925-0686
ICR 201403-0925-004
IC 208732
( )
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
View Information Collection (IC)
IC Title:
Adult Diet Survey Instrument (Attachment J)
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
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
Federal Enterprise Architecture Business Reference Module
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 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
1,250
0
0
0
0
1,250
Annual IC Time Burden (Hours)
313
0
0
0
0
313
Annual IC Cost Burden (Dollars)
0
0
0
0
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.
