Information Collection

Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews

IC 219252 under ICR 202210-0935-001 · OMB 0935-0231.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0231 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews	Form and Instruction
1 Attachment B Online Submission Form Attachment B_Onine Submission Form_Effective Health Care website 6.29.22.docx	Form and Instruction
1 Attachment B Online Submission Form Attachment B_Onine Submission Form_Effective Health Care website 6.29.22.docx	Form and Instruction

IC Title:

Website portal for Submission of Supplemental Evidence and Data for Systematic Reviews

Agency IC Tracking Number:

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
Form and Instruction	1	Attachment B Online Submission Form	Attachment B_Onine Submission Form_Effective Health Care website 6.29.22.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	200	195	5
Annual IC Time Burden (Hours)	50	49	1
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.