Information Collection

Attach 1G - CTSU Radiation Therapy Facilities Inventory Form

IC 195158 under ICR 201604-0925-004 · OMB 0925-0624.

Documents and Forms

Document Name Document Type
Form 7 Attach 1G - CTSU Radiation Therapy Facilities Inventory Form Form and Instruction
7 CTSU Radiation Therapy Facilities Inventory Form attachment_1g_rtform.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Attach 1G - CTSU Radiation Therapy Facilities Inventory Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

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	7	CTSU Radiation Therapy Facilities Inventory Form	attachment_1g_rtform.pdf		No	No	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: Clinical, Basic and Population-based Research Studies of hte National Institutes of Health (NIH), HHS/NIH/OD	FR Citation: 67 FR 60776

Number of Respondents: 20	Number of Respondents for Small Entity: 6

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	120	120
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.