Information Collection

Study 1 Screener

IC 239531 under ICR 202104-0910-001 · OMB 0910-0885.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix F - Pretest and Main Studies Recruitment Materials.docx	Other-Pretest and Main Studies Recru
Appendix F - Pretest and Main Studies Recruitment Materials.docx	Other-Pretest and Main Studies Recru
Appendix G - Screener.docx	Other-Study Screener
Appendix G - Screener.docx	Other-Study Screener

IC Title:

Study 1 Screener

Agency IC Tracking Number:

CDER

Is this a Common Form? No

IC Status: Modified

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
Other-Pretest and Main Studies Recruitment Materials			Appendix F - Pretest and Main Studies Recruitment Materials.docx		Yes	No	Printable Only
Other-Study Screener			Appendix G - Screener.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: 1,610

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	Previously Approved
Annual Number of Responses for this IC	1,610	443	1,167
Annual IC Time Burden (Hours)	129	36	93
Annual IC Cost Burden (Dollars)	0	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.