Buccal Cell Collection for Agricultural Health Study

Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Diseases Among Men and Women in Agriculture (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0406 can be found here:

Documents and Forms

Document Name Document Type
Form 15F Buccal Cell Collection for Agricultural Health Study Form and Instruction
15F Swab Attach 15F_Buccal Cell Instructions North Carolina.pdf Form and Instruction
2 CATI v. 2 Attach 2_CATI Phase III v2.doc Form
Attach 15B_Buccal Directions Iowa.doc Attach 15B_Buccal Directions Iowa IC Document

Information Collection (IC) Details

IC Title:	Buccal Cell Collection for Agricultural Health Study	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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 and Instruction	15F	Swab	Attach 15F_Buccal Cell Instructions North Carolina.pdf		Yes	Yes	Paper Only
Form	2	CATI v. 2	Attach 2_CATI Phase III v2.doc		No	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 993	Number of Respondents for Small Entity: 993

Affected Public: Private Sector	Private Sector: Farms

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	331	331
Annual IC Time Burden (Hours)	331	331
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attach 15B_Buccal Directions Iowa	Attach 15B_Buccal Directions Iowa.doc	06/19/2008

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