Information Collection

Evaluation of the Cancer Control P.L.A.N.E.T.

IC 226450 under ICR 201605-0925-007 · OMB 0925-0046.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0046 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Evaluation of the Cancer Control P.L.A.N.E.T.	Form
Attachment 2- Interview Guide.pdf	Other-Interview
1 Online Survey Attachment 1- Online survey.pdf	Form
Mini SSA PLANET.docx Evaluation of the Cancer Control P.L.A.N.E.T.	IC Document

IC Title:

Evaluation of the Cancer Control P.L.A.N.E.T.

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	1	Online Survey	Attachment 1- Online survey.pdf		Yes	Yes	Fillable Fileable
Other-Interview			Attachment 2- Interview Guide.pdf		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,100

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	2,100	2,100
Annual IC Time Burden (Hours)	445	445
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Evaluation of the Cancer Control P.L.A.N.E.T.	Mini SSA PLANET.docx	04/18/2017

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