Information Collection

Special Emphasis Panel (SEP) Peer Review Evaluation

IC 225960 under ICR 201605-0920-001 · OMB 0920-1050.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1050 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 17WN Special Emphasis Panel (SEP) Peer Review Evaluation	Form and Instruction
17WN Att 1. Instrument_Peer Reviewers' Evaluation Form 3.2.17 Att 1. Instrument_Peer Reviewers' Evaluation Form 3.2.17.docx	Form and Instruction
Service 1050 GenIC Request_Peer Review Evaulation 3.2.17.docx Service 1050 GenIC Request_Peer Review Evaulation 3.2.17	IC Document

IC Title:

Special Emphasis Panel (SEP) Peer Review Evaluation

Agency IC Tracking Number:

17WN

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	17WN	Att 1. Instrument_Peer Reviewers' Evaluation Form 3.2.17	Att 1. Instrument_Peer Reviewers' Evaluation Form 3.2.17.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 350

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	350	350
Annual IC Time Burden (Hours)	88	88
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Service 1050 GenIC Request_Peer Review Evaulation 3.2.17	Service 1050 GenIC Request_Peer Review Evaulation 3.2.17.docx	03/02/2017

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