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Federal forms, ICRs, and supporting documents

Information Collection Request

VA Cooperative Study Project #500A, National Registry of Veterans with Amyotrophic Lateral Sclerosis (ALS)

ICR 200309-2900-003 · OMB 2900-0649 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
28925 VA Cooperative Study Project #500A, National Registry of Veterans with Amyotrophic Lateral Sclerosis (ALS) Form Migrated
ICR Details
2900-0649 200309-2900-003
Historical Active
VA
VA Cooperative Study Project #500A, National Registry of Veterans with Amyotrophic Lateral Sclerosis (ALS)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/10/2003
Retrieve Notice of Action (NOA) 09/17/2003
  Inventory as of this Action Requested Previously Approved
12/31/2006 12/31/2006
3,822 0 0
1,808 0 0
0 0 0
Purpose is to understand the natural history of ALS, provide crucial epidemilogical data on vet population with ALS, assist in early identification of ALS cases and clusters as well as provide means of informing vets of new clincial drug trials and studies.
None
None
No
1
IC Title Form No. Form Name
VA Cooperative Study Project #500A, National Registry of Veterans with Amyotrophic Lateral Sclerosis (ALS) 10-21047(NR), 10-21047A(NR), 10-1086
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,822 0 0 3,822 0 0
Annual Time Burden (Hours) 1,808 0 0 1,808 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/17/2003