Information Collection

Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS)

IC 234245 under ICR 201802-0925-002 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS)	Form
1 Equipment Survey 11292018_EquipmentSurvey NIEHS.docx	Form
Generic Clearance Submission Gary Bird for NTA v. 2 2018-11-29.docx Gary Bird for NTA fast track	IC Document
Email to NTA participants.docx email to NTA participants	IC Document

IC Title:

Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS)

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	Equipment Survey	11292018_EquipmentSurvey NIEHS.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

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	200	200
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Gary Bird for NTA fast track	Generic Clearance Submission Gary Bird for NTA v. 2 2018-11-29.docx	11/29/2018
email to NTA participants	Email to NTA participants.docx	11/29/2018

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