Information Collection

Referees

IC 182094 under ICR 200709-0925-001 · OMB 0925-0378.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0378 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Referees	Form and Instruction
1 Application for Pharmacology Research Associate Program Application_part1_fillable.revised.pdf	Form and Instruction
2 Preceptor Selection Verification Form Application_part2.pdf	Form and Instruction
3 Pharmacology Research Associate Program Request for Eval Application_part3.pdf	Form and Instruction
Introductory Letter.doc Introductory Letter	IC Document

IC Title:

Referees

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Application for Pharmacology Research Associate Program	Application_part1_fillable.revised.pdf	Yes	Yes	Paper Only
Form and Instruction	2	Preceptor Selection Verification Form	Application_part2.pdf	Yes	Yes	Paper Only
Form and Instruction	3	Pharmacology Research Associate Program Request for Evaluation of Applicant	Application_part3.pdf	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

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	75	75
Annual IC Time Burden (Hours)	131	131
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Introductory Letter	Introductory Letter.doc	09/18/2007

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