Information Collection

Data and Safety Monitoring Meeting Evaluation

IC 226348 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⚠️ Notice: This information collection may be referencing outdated material.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 Data and Safety Monitoring Meeting Evaluation	Form and Instruction
1 KAI Research Questions for NIAMS Customer Survey KAI Research_Questions for NIAMS Customer Survey (003).docx	Form and Instruction
1 (Screenshots) KAI Research Questions for NIAMS Customer Survey KAI Research_Questions for NIAMS Customer Survey (003).docx	Form and Instruction
KAI Research_Fast Track Template 4-4-2017.doc Data and Safety Monitoring Meeting Evaluation	IC Document

IC Title:

Data and Safety Monitoring Meeting Evaluation

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	KAI Research Questions for NIAMS Customer Survey	KAI Research_Questions for NIAMS Customer Survey (003).docx		Yes	Yes	Fillable Fileable
Form and Instruction	1 (Screenshots)	KAI Research Questions for NIAMS Customer Survey	KAI Research_Questions for NIAMS Customer Survey (003).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

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	300	300
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Data and Safety Monitoring Meeting Evaluation	KAI Research_Fast Track Template 4-4-2017.doc	04/11/2017

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