Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS) Form
1 Equipment Survey 11292018_EquipmentSurvey NIEHS.docx Form
Generic Clearance Submission Gary Bird for NTA v. 2 2018-11-29.docx Gary Bird for NTA fast track IC Document
Email to NTA participants.docx email to NTA participants IC Document

Information Collection (IC) Details

IC Title:	Questionnaire for assessing the needs to innovate, build, modify and fix laboratory tools & equipment (NIEHS)	Agency IC Tracking Number:

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	1	Equipment Survey	11292018_EquipmentSurvey NIEHS.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Gary Bird for NTA fast track	Generic Clearance Submission Gary Bird for NTA v. 2 2018-11-29.docx	11/29/2018
email to NTA participants	Email to NTA participants.docx	11/29/2018

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