Information Collection

2023 NIAMS Coalition Outreach & Education Meeting Living With Materials Survey

IC 262124 under ICR 202103-0925-003 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Survey (Word Version) 2023 NIAMS Coalition Outreach & Education Meeting Living With Materials Survey	Form
Form 2 Survey (Screenshots) 2023 NIAMS Coalition Outreach & Education Meeting Living With Materials Survey	Form
1 Survey (Word Version) Attachment A_O&E Day_Living With Survey.docx	Form
2 Survey (Screenshots) Attachment B_Survey Screenshots.docx	Form
OMB FORM_NIAMS_O&E Day Living With Survey.docx Template	IC Document
Attachment C_NIAMS OE Day Survey QR Code.docx QR Code	IC Document

IC Title:

2023 NIAMS Coalition Outreach & Education Meeting Living With Materials Survey

Agency IC Tracking Number:

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	1				Yes	Yes	Paper Only
Form	2				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 32

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	32	32
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
Template		09/12/2023
QR Code		09/13/2023

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

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