MOSAIC Study Sign Up and Informed Consent

Understanding Resource Utilization to Support Male Sailor Operational Readiness (MOSAIC)

Documents and Forms

Document Name Document Type
0703-0099_MOSAIC Sign-up Form.pdf Other-Web Form
0703-0099_MOSAIC Informed Consent.pdf Other-Informed Consent

Information Collection (IC) Details

IC Title:	MOSAIC Study Sign Up and Informed Consent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Web Form			0703-0099_MOSAIC Sign-up Form.pdf		Yes	Yes	Fillable Fileable
Other-Informed Consent			0703-0099_MOSAIC Informed Consent.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	10	10
Annual IC Cost Burden (Dollars)	152	152

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.