Information Program on Clinical Trials for Serious and Life-Threatening Diseases: Maintaining a Databank

Documents and Forms

Document Name Document Type
0459CMS portion Instrument Data Element Definitions.doc Other-Data Element Definitions (CMS)

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Information Program on Clinical Trials for Serious and Life-Threatening Diseases: Maintaining a Databank	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Data Element Definitions (CMS)			0459CMS portion Instrument Data Element Definitions.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 745	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	745	745
Annual IC Time Burden (Hours)	4,172	4,172
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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