Information Collection

Pilot Survey Communications Fellowship (NCF) Program Application (NCI)

IC 234704 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⚠️ Notice: This information collection may be referencing outdated material.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 Pilot Survey Communications Fellowship (NCF) Program Application (NCI)	Form
1 NCF Applications Attach1-NCF Application.pdf	Form
2 NCF Feedback Survey Attach2-NCF Feedback Survey.docx	Form
3 NCF References Attach3-NCF Reference.pdf	Form and Instruction
mini SSA_NCF 01-10-2019.docx Mini SSA NCI Communication Fellowship Program Applicaiton	IC Document
Attach4-NCF Automated Emails w Descriptions.docx NCF Automated Emails w Descriptions	IC Document

IC Title:

Pilot Survey Communications Fellowship (NCF) Program Application (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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	NCF Applications	Attach1-NCF Application.pdf	Yes	Yes	Fillable Fileable
Form	2	NCF Feedback Survey	Attach2-NCF Feedback Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	3	NCF References	Attach3-NCF Reference.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 360

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	480	480
Annual IC Time Burden (Hours)	246	246
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Mini SSA NCI Communication Fellowship Program Applicaiton	mini SSA_NCF 01-10-2019.docx	01/10/2019
NCF Automated Emails w Descriptions	Attach4-NCF Automated Emails w Descriptions.docx	01/10/2019

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