Information Collection

Main Study

IC 214502 under ICR 201510-0910-006 · OMB 0910-0785.

Documents and Forms

Document Name Document Type
0785 Questionnaire Revised 10-15-2015.docx Other-Questionnaire

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Main Study	Agency IC Tracking Number:	CDER

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 21 CFR 202.1(e)(5)(i) 21 CFR 202.1(e)(6)(i) 21 CFR 202.1(e)(3)(ii)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire			0785 Questionnaire Revised 10-15-2015.docx		Yes	Yes	Fillable Fileable Signable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	750	750
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.