Information Collection

Study 1 - Pretest

IC 244269 under ICR 202010-0910-011 · OMB 0910-0894.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A - Endorsement Questionnaires.docx	Other-Survey Questionnaire
Appendix A - Endorsement Questionnaires.docx	Other-Survey Questionnaire
Appendix C - Recruitment.docx	Other-Recruitment Email
Appendix C - Recruitment.docx	Other-Recruitment Email
Appendix D - Informed Consent.docx	Other-Informed Consent
Appendix D - Informed Consent.docx	Other-Informed Consent

IC Title:

Study 1 - Pretest

Agency IC Tracking Number:

CDER

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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Questionnaire	Appendix A - Endorsement Questionnaires.docx	Yes	Yes	Fillable Fileable
Other-Recruitment Email	Appendix C - Recruitment.docx	Yes	No	Printable Only
Other-Informed Consent	Appendix D - Informed Consent.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: 249

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	249	249
Annual IC Time Burden (Hours)	82	82
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.