Federalwide Assurance (FWA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0278 can be found here:

Documents and Forms

Document Name Document Type
Form 0990-0278 Federalwide Assurance (FWA) Form and Instruction
0990-0278-Proposed Terms of the Federalwide Assurance PRA _ 31 March 2011.docx Instruction
0990-0278-Proposed Instructions for the Federalwide Assurance PRA to Toni_31 March 2011.doc Instruction
0990-0278 FWA 0990-0278-Proposed FWA Form-For both US and non-US institutions_PRA _31 March 2011.doc Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Federalwide Assurance (FWA)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 45 CFR 46

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	0990-0278	FWA	0990-0278-Proposed FWA Form-For both US and non-US institutions_PRA _31 March 2011.doc	Yes	Yes	Fillable Fileable
Instruction			0990-0278-Proposed Terms of the Federalwide Assurance PRA _ 31 March 2011.docx	Yes	Yes	Fillable Fileable
Instruction			0990-0278-Proposed Instructions for the Federalwide Assurance PRA to Toni_31 March 2011.doc	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 11,000	Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	22,000	2,000	20,000
Annual IC Time Burden (Hours)	11,000	-4,000	15,000
Annual IC Cost Burden (Dollars)	0	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.