2019 NCI Director's Awards Ceremony Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form 1 2019 NCI Director's Awards Ceremony Survey Form and Instruction
1 NCI Awards Survey NCI Awards Survey.pdf Form and Instruction
Fast Track Request NCI Directors Award 2019.docx Fast-Track Template IC Document
Survey email invite .docx Email Invite IC Document

Information Collection (IC) Details

IC Title:	2019 NCI Director's Awards Ceremony Survey	Agency IC Tracking Number:

IC Status: New

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	1	NCI Awards Survey	NCI Awards Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast-Track Template	Fast Track Request NCI Directors Award 2019.docx	12/05/2019
Email Invite	Survey email invite .docx	12/05/2019

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