Information Collection

Cancer Info Call Backs

IC 251014 under ICR 202504-0925-001 · OMB 0925-0208.

Documents and Forms

Document Name Document Type
Form 1 Cancer Info Call Backs Form
Form 1 Cancer Information Call Backs Cancer Info Call Backs Form
1 Cancer Information Call Backs Appendix 1F Cancer Information CT Callbacks.docx Form
1 Cancer Information Call Backs Appendix 1F Cancer Information CT Callbacks.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Cancer Info Call Backs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Cancer Information Call Backs	Appendix 1F Cancer Information CT Callbacks.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0156, âRecords of Participants in Programs and Respondents in Surveys Used to Evaluate Programs of the Public Health Service	FR Citation: 67 FR 60742

Number of Respondents: 1,841	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,841	1,841
Annual IC Time Burden (Hours)	123	123
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.

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