Information Collection

Attachment C1 Initial Biospecimen and Cancer Count Information Spreadsheet

IC 213181 under ICR 201409-0925-003 · OMB 0925-0706.

Documents and Forms

Document Name Document Type
Form 4 Attachment C1 Initial Biospecimen and Cancer Count Information Spreadsheet Form and Instruction
4 Initial Biospecimen and Cancer Count Information Form Attachment C1_CEDCD Biospecimen and Cancer Count Information Form.xlsx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Attachment C1 Initial Biospecimen and Cancer Count Information Spreadsheet	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	4	Initial Biospecimen and Cancer Count Information Form	Attachment C1_CEDCD Biospecimen and Cancer Count Information Form.xlsx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	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.