Information Collection

Study 2

IC 239534 under ICR 202007-0910-004 · OMB 0910-0885.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0885 can be found here:

Documents and Forms

Document Name Document Type
Appendix A - Study Pretests and Main Studies Consent Form.docx Other-Pretests and Main Studies Cons
Appendix D - Study 2 Questionnaire.docx Other-Survey Instrument

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Study 2	Agency IC Tracking Number:	CDER

Is this a Common Form? No		IC Status: Unchanged

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
Other-Pretests and Main Studies Consent Form			Appendix A - Study Pretests and Main Studies Consent Form.docx		Yes	Yes	Fillable Fileable
Other-Survey Instrument			Appendix D - Study 2 Questionnaire.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 520	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	520	520
Annual IC Time Burden (Hours)	172	172
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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