OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

epidemiology and Genomics Research Program (EGRP) Communications Survey

IC 214259 under ICR 201406-0925-004 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 epidemiology and Genomics Research Program (EGRP) Communications Survey	Form and Instruction
1 Attachment 1 EGRP Communications Survey Attachment 1 EGRP Communications Survey.pdf	Form and Instruction
Fast-Track_Request_EGRPrevised 12.10.14.docx Fast Track Template for EGRP	IC Document
Attachment 2 Invitations.doc Attachment 2 Invitations	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

epidemiology and Genomics Research Program (EGRP) Communications Survey

Agency IC Tracking Number:

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 and Instruction	1	Attachment 1 EGRP Communications Survey	Attachment 1 EGRP Communications Survey.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

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 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	500	0	500	0	0	0
Annual IC Time Burden (Hours)	125	0	125	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Template for EGRP	Fast-Track_Request_EGRPrevised 12.10.14.docx	12/15/2014
Attachment 2 Invitations	Attachment 2 Invitations.doc	12/15/2014

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