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CEDCD Annual Data Collection Form
Data Collection for Public Cancer Epidemiology Descriptive Cohort Database (NCI)
OMB: 0925-0706
IC ID: 213180
OMB.report
HHS/NIH
OMB 0925-0706
ICR 201409-0925-003
IC 213180
( )
Documents and Forms
Document Name
Document Type
Form 3
CEDCD Annual Data Collection Form
Form and Instruction
3 Attachment B2 CEDCD Annual Update Data Collection Form
Attachment B2_CEDCD Annual Update Data Collection Form.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
CEDCD Annual Data Collection Form
Agency IC Tracking Number:
Is this a Common Form?
No
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
3
Attachment B2 CEDCD Annual Update Data Collection Form
Attachment B2_CEDCD Annual Update Data Collection Form.docx
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:
200
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
200
0
200
0
0
0
Annual IC Time Burden (Hours)
150
0
150
0
0
0
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.