Information Collection

Evaluation of the Impact of New NIH Conflicts of Interest Regulations

IC 179139 under ICR 200703-0925-003 · OMB 0925-0579.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Evaluation of the Impact of New NIH Conflicts of Interest Regulations	Form
1 Survey Attachment 2 Potential survey[1].doc	Form
Attachment 4_OHSR Document[1].pdf Attachment 4_OHSR Document[1]	IC Document
Attachment 5 Privacy Act 11_2006[1].pdf Attachment 5 Privacy Act 11_2006[1]	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Survey	Attachment 2 Potential survey[1].doc		No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 4_OHSR Document[1]	Attachment 4_OHSR Document[1].pdf
Attachment 5 Privacy Act 11_2006[1]	Attachment 5 Privacy Act 11_2006[1].pdf

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