NCI Cohort Consortium Steering Committee Elections

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 NCI Cohort Consortium Steering Committee Elections Form and Instruction
1 Survey Screenshot Survey Screenshot.docx Form and Instruction
Email text to Cohort Consortium PIs to vote.doc Email text to Cohort Consortium PIs to vote IC Document
Fast Track Request Cohort Consortium.docx Fast Track Request Cohort Consortium IC Document

Information Collection (IC) Details

IC Title:	NCI Cohort Consortium Steering Committee Elections	Agency IC Tracking Number:

IC Status: New

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	Survey Screenshot	Survey Screenshot.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	55	55
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Email text to Cohort Consortium PIs to vote	Email text to Cohort Consortium PIs to vote.doc	12/11/2015
Fast Track Request Cohort Consortium	Fast Track Request Cohort Consortium.docx	12/11/2015

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