Information Collection

Bench to Bedside Immunology Module-- Outcomes Evaluation (Federal)

IC 240850 under ICR 202003-0925-006 · OMB 0925-0768.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 Bench to Bedside Immunology Module-- Outcomes Evaluation (Federal)	Form
4 Outcomes Evaluation Attachment 4-Outcomes Evaluation (1).docx	Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Bench to Bedside Immunology Module-- Outcomes Evaluation (Federal)

Agency IC Tracking Number:

Is this a Common Form? No

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	4	Outcomes Evaluation	Attachment 4-Outcomes Evaluation (1).docx		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: 09-25-0108, Personnel: Guest Researchers, Special Volunteers, and Scientists Emeriti, HHS/NIH/OHRM; OPM/GOVT-6, Personnel Research and Test Validation Records; and OPM/GOVT-1, General Personnel Record

FR Citation: 67 FR 60742

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

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	30	30
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.