Information Collection

The Cognition and Medical Image Perception Think Tank Registration Form (NCI)

IC 237258 under ICR 202010-0925-003 · OMB 0925-0740.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0740 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 The Cognition and Medical Image Perception Think Tank Registration Form (NCI)	Form
1 Registration Page Registration Page Cognitive and Medical Image Perception Think Tank.pdf	Form
Request for Cognitive Think Tank.docx Request for Cognitive Think Tank	IC Document
Cognitive Think Tank Registration Form.docx Cognitive Think Tank Registration Form	IC Document

IC Title:

The Cognition and Medical Image Perception Think Tank Registration Form (NCI)

Agency IC Tracking Number:

IC Status: Unchanged

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	1	Registration Page	Registration Page Cognitive and Medical Image Perception Think Tank.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	7	7
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Cognitive Think Tank	Request for Cognitive Think Tank.docx	08/05/2019
Cognitive Think Tank Registration Form	Cognitive Think Tank Registration Form.docx	08/05/2019

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