0847 Template

Template for Data to Support Social and Behavioral Research.doc

Data To Support Social and Behavioral Research as Used by the Food and Drug Administration

0847 Template

OMB: 0910-0847

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FDA DOCUMENTATION FOR THE GENERIC CLEARANCE

OF REQUEST FOR DATA TO SUPPORT SOCIAL AND BEHAVIORAL RESEARCH (0910-0847)


TITLE OF INFORMATION COLLECTION:


DESCRIPTION OF THIS SPECIFIC COLLECTION

  1. Statement of need:



  1. Intended use of information:



  1. Description of respondents:



  1. Date(s) to be conducted:


  1. How the information is being collected:



  1. Confidentiality of respondents:



  1. Amount and justification for any proposed incentive:



  1. Questions of a sensitive nature:



  1. Description of statistical methods:


BURDEN HOUR COMPUTATION:


Type/Category of Respondent

No. of Respondents

Participation Time (minutes)

Burden

(hours)






REQUESTED APPROVAL DATE:


NAME OF PRA ANALYST & PROGRAM CONTACT:


PRA Analyst


Program Contact

FDA CENTER:

1

File Typeapplication/msword
File TitleOMBMemoMERCPtP
SubjectMERC OMB MEP
AuthorStClair, Christopher
Last Modified BySYSTEM
File Modified2019-12-12
File Created2019-12-12

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