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Web-based Update Mailer Attachment 3
NCI Cancer Genetics Services Directory Web-Based Application and Update Mailer
OMB: 0925-0639
IC ID: 212546
OMB.report
HHS/NIH
OMB 0925-0639
ICR 201711-0925-004
IC 212546
( )
Documents and Forms
Document Name
Document Type
Form 2
Web-based Update Mailer Attachment 3
Form and Instruction
2 Web-based Update Mailer
Attachment 3 Web-based Update Mailer.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Web-based Update Mailer Attachment 3
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
2
Web-based Update Mailer
Attachment 3 Web-based Update Mailer.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
600
0
600
0
0
0
Annual IC Time Burden (Hours)
150
0
150
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.