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Interviewer Administrative Forms (Attachment 9)
A multi-center international hospital-based case-control study of lymphoma in Asia (AsiaLymph) (NCI)
OMB: 0925-0654
IC ID: 201514
OMB.report
HHS/NIH
OMB 0925-0654
ICR 201510-0925-005
IC 201514
( )
Documents and Forms
Document Name
Document Type
Form 9
Interviewer Administrative Forms (Attachment 9)
Form and Instruction
9 Administrative forms for the Interviewer
Attach 9 -_Admin_forms_interviewers_REV_07_02_12.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Interviewer Administrative Forms (Attachment 9)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
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
9
Administrative forms for the Interviewer
Attach 9 -_Admin_forms_interviewers_REV_07_02_12.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
19
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
0
0
-2,204
0
0
2,204
Annual IC Time Burden (Hours)
0
0
-1,102
0
0
1,102
Annual IC Cost Burden (Dollars)
0
0
0
0
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.