NIH CAP 2013 Feedback Form

GENERIC CLEARANCE FOR SURVEYS OF THE OFFICE OF EXTRAMURAL RESEARCH (OD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0627 can be found here:

Documents and Forms

Document Name Document Type
Form 1 NIH CAP 2013 Feedback Form Form and Instruction
1 CAP Feedback Form (Screenshot) CAP_Feedback_Screenshot_9.9.13_Revised.docx Form and Instruction
CAP_Feedback_Form_2013_9.9.13.doc CAP Feedback Form (Word Version) IC Document
SBIR_STTR_CAP_Survey_OMB_Cover_Submission_Memo Clean 9.9.doc Gen IC Justification IC Document
SBIR CAP SUBMISSION OF INFORMATION COLLECTION with PCB comments 9.6.doc Generic Cover Sheet IC Document

Information Collection (IC) Details

IC Title:	NIH CAP 2013 Feedback Form	Agency IC Tracking Number:

IC Status: New

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
Form and Instruction	1	CAP Feedback Form (Screenshot)	CAP_Feedback_Screenshot_9.9.13_Revised.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 68	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	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	68	0	0	0	0	0
Annual IC Time Burden (Hours)	17	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
CAP Feedback Form (Word Version)	CAP_Feedback_Form_2013_9.9.13.doc	09/12/2013
Gen IC Justification	SBIR_STTR_CAP_Survey_OMB_Cover_Submission_Memo Clean 9.9.doc	09/12/2013
Generic Cover Sheet	SBIR CAP SUBMISSION OF INFORMATION COLLECTION with PCB comments 9.6.doc	09/12/2013

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