Information Collection

Research Advocate System

IC 212181 under ICR 201106-0925-002 · OMB 0925-0641.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0641 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Research Advocate System	Form and Instruction
1 Registration/Annual Update Form Attachment 3 Screenshots.pdf	Form and Instruction
2 Telephone Screening Form Attachment 7 Telephone Screener Script.docx	Form and Instruction
Attachment 1_PIA_OAR.xml PIA	IC Document
Attachment 2 OHSRP Exclusion.pdf IRB Letter	IC Document
Attachment 4_Invitations.doc Invitations	IC Document
Attachment 5 Auto-Reply Email.docx Attachment 5 Auto-Reply E-mail	IC Document
Attachment 6 Annual Update Reminder.docx Attachment 6 Annual Update Remiinder	IC Document
miniSSA OAR Applications 7 3 2014.docx Justification/Mini SSA	IC Document

IC Title:

Research Advocate System

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	Registration/Annual Update Form	Attachment 3 Screenshots.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	2	Telephone Screening Form	Attachment 7 Telephone Screener Script.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	120	120
Annual IC Time Burden (Hours)	43	43
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
PIA	Attachment 1_PIA_OAR.xml	07/01/2014
IRB Letter	Attachment 2 OHSRP Exclusion.pdf	07/01/2014
Invitations	Attachment 4_Invitations.doc	07/01/2014
Attachment 5 Auto-Reply E-mail	Attachment 5 Auto-Reply Email.docx	07/03/2014
Attachment 6 Annual Update Remiinder	Attachment 6 Annual Update Reminder.docx	07/03/2014
Justification/Mini SSA	miniSSA OAR Applications 7 3 2014.docx	07/03/2014

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