Information Collection

Pre-meeting Survey for the NCI Cohort Consortium

IC 231476 under ICR 201905-0925-001 · OMB 0925-0642.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Pre-meeting Survey for the NCI Cohort Consortium	Form and Instruction
1 screenshots - Survey Cohort Consortium Screenshots - Survey Cohort Consortium final.pdf	Form and Instruction
Cohort Consortium - Fast Track Submission.docx Cohort Consortium fast track	IC Document

IC Title:

Pre-meeting Survey for the NCI Cohort Consortium

Agency IC Tracking Number:

IC Status: Unchanged

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 and Instruction	1	screenshots - Survey Cohort Consortium	Screenshots - Survey Cohort Consortium final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

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
	Requested	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Cohort Consortium fast track	Cohort Consortium - Fast Track Submission.docx	05/16/2018

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