Information Collection

Notice of Research Exception under the Genetic Information Nondiscrimination Act (GINA)

IC 191067 under ICR 200910-0938-010 · OMB 0938-1077.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1077 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10286 Notice of Research Exception under the Genetic Information Nondiscrimination Act (GINA) Form and Instruction
CMS-10286 Notice of Research Exception for The Genetic Information CMS-10286.GINA Research Exception Notice.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notice of Research Exception under the Genetic Information Nondiscrimination Act (GINA)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 146.122(c)(5)(iv) 45 CFR 148.180(e)(5)(iv)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10286	Notice of Research Exception for The Genetic Information Nondiscrimination Act	CMS-10286.GINA Research Exception Notice.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

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.