Information Collection

Evidence-Based Cancer Control Programs (EBCCP) Bulletin Feature Questionnaire (NCI)

IC 279792 under ICR 202406-0925-001 · OMB 0925-0648.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Questionnaire Evidence-Based Cancer Control Programs (EBCCP) Bulletin Feature Questionnaire (NCI)	Form
1 Questionnaire Instrument_EBCCP Bulletin.pdf	Form
Sub Study_0925-0648-2604 _EBCCP Bulletin.docx Template	IC Document
Recruitment Material_EBCCP Bulletin.docx Correspondence	IC Document

IC Title:

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	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Records of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service

FR Citation: 83 FR 6591

Number of Respondents: 16

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	16	16
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template		04/06/2026
Correspondence		04/06/2026

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

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