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Attach 1G - CTSU Radiation Therapy Facilities Inventory Form
Cancer Trials Support Unit (CTSU) Public Use Forms and Customer Satisfaction Surveys (NCI)
OMB: 0925-0624
IC ID: 195158
OMB.report
HHS/NIH
OMB 0925-0624
ICR 201604-0925-004
IC 195158
( )
Documents and Forms
Document Name
Document Type
Form 7
Attach 1G - CTSU Radiation Therapy Facilities Inventory Form
Form and Instruction
7 CTSU Radiation Therapy Facilities Inventory Form
attachment_1g_rtform.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Attach 1G - CTSU Radiation Therapy Facilities Inventory Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
7
CTSU Radiation Therapy Facilities Inventory Form
attachment_1g_rtform.pdf
No
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
Clinical, Basic and Population-based Research Studies of hte National Institutes of Health (NIH), HHS/NIH/OD
FR Citation:
67 FR 60776
Number of Respondents:
20
Number of Respondents for Small Entity:
6
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
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
240
0
0
0
0
240
Annual IC Time Burden (Hours)
120
0
0
0
0
120
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.