Information Collection

NLM 4 Caregivers User Survey

IC 224307 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⚠️ Notice: This information collection may be referencing outdated material.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 NLM 4 Caregivers User Survey	Form and Instruction
1 NLM 4 Caregivers 2016 User Survey Instrument NLM 4 Caregivers 2016 User Survey Instrument.pdf	Form and Instruction
NIH Fast Track ICR_NLM 4 Caregivers User Survey.doc NLM 4 Caregivers User Survey	IC Document

IC Title:

NLM 4 Caregivers User 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	NLM 4 Caregivers 2016 User Survey Instrument	NLM 4 Caregivers 2016 User Survey Instrument.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	500	500
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NLM 4 Caregivers User Survey	NIH Fast Track ICR_NLM 4 Caregivers User Survey.doc	11/03/2016

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