Information Collection

Number to Complete the Screener (10%) - Study 2

IC 220729 under ICR 201603-0910-012 · OMB 0910-0821.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0821 can be found here:

Documents and Forms

Document Name Document Type
Appendix D - SCREENER.doc Other-Screener
Appendix E - RECRUITMENT EMAILS.doc Recruitment Emails IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Number to Complete the Screener (10%) - Study 2	Agency IC Tracking Number:	CDER

Is this a Common Form? No		IC Status: New

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
Other-Screener			Appendix D - SCREENER.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,513	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,513	1,513
Annual IC Time Burden (Hours)	76	76
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Recruitment Emails	Appendix E - RECRUITMENT EMAILS.doc	03/24/2016

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