Information Collection

The Cognition and Medical Image Perception Think Tank Registration Form (NCI)

IC 236265 under ICR 201602-0925-001 · OMB 0925-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 The Cognition and Medical Image Perception Think Tank Registration Form (NCI)	Form and Instruction
1 Cognitive Think Tank Registration Form OMB PRA_Cognitive Think Tank_052019 Registration Form.docx	Form and Instruction
Request Cognitive Think Tank final.docx Request for Cognitive Think Tank	IC Document
You're Invited Cognition and Medical Image Perception Think Tank - email.msg invitation	IC Document

IC Title:

The Cognition and Medical Image Perception Think Tank Registration Form (NCI)

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	Cognitive Think Tank Registration Form	OMB PRA_Cognitive Think Tank_052019 Registration Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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	40	40
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Cognitive Think Tank	Request Cognitive Think Tank final.docx	05/30/2019
invitation	You're Invited Cognition and Medical Image Perception Think Tank - email.msg	05/30/2019

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