OMB
.report
Search
NCI CIRB Institution Enrollment Worksheet (Attach 2C)
NIH NCI Central Institutional Review Board (CIRB) Initiative (NCI)
OMB: 0925-0625
IC ID: 195525
OMB.report
HHS/NIH
OMB 0925-0625
ICR 201311-0925-004
IC 195525
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0625 can be found here:
2014-02-14 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Form 2c
NCI CIRB Institution Enrollment Worksheet (Attach 2C)
Form and Instruction
2c NCI CIRB Signatory
2C_NCI_CIRB_Enrollment_Form_06212013.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
NCI CIRB Institution Enrollment Worksheet (Attach 2C)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
2c
NCI CIRB Signatory
2C_NCI_CIRB_Enrollment_Form_06212013.doc
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
09-25-0200 "Clinical, Basic and Population-based Research Studies of the Natonal Institutes of Health (NIH), HHS/NIH/OD"
FR Citation:
67 FR 60776
Number of Respondents:
40
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
40
0
10
0
0
30
Annual IC Time Burden (Hours)
160
0
55
0
0
105
Annual IC Cost Burden (Dollars)
0
0
0
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.