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Adult Initial Review of Cooperative Group Protocol (Attach 6A)
NIH NCI Central Institutional Review Board (CIRB) Initiative (NCI)
OMB: 0925-0625
IC ID: 195548
OMB.report
HHS/NIH
OMB 0925-0625
ICR 201402-0925-001
IC 195548
( )
Documents and Forms
Document Name
Document Type
Form 6A
Adult Initial Review of Cooperative Group Protocol (Attach 6A)
Form and Instruction
6A Adult Initial Review of Cooperative Group Protocol REV
6A_IR_FB_ADULT_Reviewer Worksheet_REV.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Adult Initial Review of Cooperative Group Protocol (Attach 6A)
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
6A
Adult Initial Review of Cooperative Group Protocol REV
6A_IR_FB_ADULT_Reviewer Worksheet_REV.docx
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:
15
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
15
0
0
0
0
15
Annual IC Time Burden (Hours)
60
0
0
0
0
60
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.