NCI CIRB Institution Enrollment Worksheet (Attach 2C)

NIH NCI Central Institutional Review Board (CIRB) Initiative (NCI)

Documents and Forms

Document Name Document Type
Form 2C NCI CIRB Institution Enrollment Worksheet (Attach 2C) Form and Instruction
2C NCI IRB Enrollment Form REV 2C_NCI_CIRB_Enrollment_Form_REV.doc Form and Instruction

Information Collection (IC) Details

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 IRB Enrollment Form REV	2C_NCI_CIRB_Enrollment_Form_REV.doc		Yes	Yes	Fillable Fileable

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	Previously Approved
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	160	160
Annual IC Cost Burden (Dollars)	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.