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Federal forms, ICRs, and supporting documents

Information Collection

Attachment 2 - Survey of Applicants

IC 209807 under ICR 201403-0925-005 · OMB 0925-0690.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Attachment 2 - Survey of Applicants
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2 SURVEY OF APPLICANTS Revised Attach B_Survey Applicants_REV-2-25-2014.docx Yes Yes Fillable Fileable
Form and Instruction 2 SURVEY OF APPLICANTS Attach 2B.Survey of Applicants (Word Document).11-5-13.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service, HHS/PHS/NIH/OD  67 FR 60743

170 0
   
Individuals or Households
 
   100 %

  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 170 0 0 0 0 170
Annual IC Time Burden (Hours) 57 0 0 0 0 57
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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