DCCPS Biorepository Information Gathering Survey (NCI)

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0642 can be found here:

Documents and Forms

Document Name Document Type
Form 1 DCCPS Biorepository Information Gathering Survey (NCI) Form and Instruction
1 Biorespository survey Biorepository Survey 5.10.19 (4).docx Form and Instruction
Fast Track Request Template Biorepository 5.10.19 (3).docx Fast track Template Biorepository IC Document
Biorepository email.docx email invite IC Document

Information Collection (IC) Details

IC Title:	DCCPS Biorepository Information Gathering Survey (NCI)	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 and Instruction	1	Biorespository survey	Biorepository Survey 5.10.19 (4).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 340	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	340	340
Annual IC Time Burden (Hours)	51	51
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast track Template Biorepository	Fast Track Request Template Biorepository 5.10.19 (3).docx	05/20/2019
email invite	Biorepository email.docx	05/20/2019

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