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Att 6 DLW Protocol and Form.doc
Interactive Diet and Activity Tracking in AARP (iDATA): Biomarker Based Validation Study (NCI)
OMB: 0925-0640
IC ID: 197720
OMB.report
HHS/NIH
OMB 0925-0640
ICR 201105-0925-003
IC 197720
( )
Documents and Forms
Document Name
Document Type
Form 4
Att 6 DLW Protocol and Form.doc
Form
4 Att 6 DLW Protocol and Form.doc
Att.6 DLW Protocol and Form.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Att 6 DLW Protocol and Form.doc
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
4
Att 6 DLW Protocol and Form.doc
Att.6 DLW Protocol and Form.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
SORN #09-25-200, "Clinical, Basic, and Population-based Research Studies of the National Institutes of Health (NIH), HHS/NIH/OD."
FR Citation:
67 FR 60776
Number of Respondents:
776
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
776
0
776
0
0
0
Annual IC Time Burden (Hours)
517
0
517
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.