Information Collection

Fourth Survey NM Module (Attachment 1B)

IC 200489 under ICR 201605-0925-012 · OMB 0925-0656.

Documents and Forms

Document Name Document Type
Form 1B Fourth Survey NM Module (Attachment 1B) Form and Instruction
1B Nuclear Medicine Module Attachment 1B-NuclearMed_091411.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Fourth Survey NM Module (Attachment 1B)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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	1B	Nuclear Medicine Module	Attachment 1B-NuclearMed_091411.pdf		Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title: SORN #09-25-0200, "Clinical, Basic and Population-based Research Studies of the National Institutes of Health (NIH), HHS/NIH/OD"	FR Citation: 67 FR 60776

Number of Respondents: 7,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-7,000	7,000
Annual IC Time Burden (Hours)	-2,333	2,333
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.