Information Collection

NIH CAP 2013 Feedback Form

IC 208637 under ICR 201103-0925-002 · OMB 0925-0627.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

IC Title:

NIH CAP 2013 Feedback Form

Agency IC Tracking Number:

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 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 %

table that charts list of burden
	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

table that charts IC Documents
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.