Information Collection

Traveling Exhibition Host Survey

IC 219124 under ICR 201501-0925-004 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Traveling Exhibition Host Survey	Form and Instruction
Attachment2-NLM Traveling Exhibition Email solicitation scripts.docx	Other-Email
1 Host Survey Attachment1-NLM Traveling Exhibition Host Survey instrument.pdf	Form and Instruction
NIH fast track clearance request - NLM Traveling Exhibition Survey.docx Fast-Track Template	IC Document

IC Title:

Traveling Exhibition Host 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	Host Survey	Attachment1-NLM Traveling Exhibition Host Survey instrument.pdf		Yes	Yes	Fillable Fileable
Other-Email			Attachment2-NLM Traveling Exhibition Email solicitation scripts.docx		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

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 Agency Discretion
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	117	117
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast-Track Template	NIH fast track clearance request - NLM Traveling Exhibition Survey.docx	12/01/2015

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