Information Collection

Authorization Agreement and Division of Responsibilities b/w NCI CIRB and Signatory Institution (Attach 2B)

IC 209457 under ICR 201402-0925-001 · OMB 0925-0625.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2B Authorization Agreement and Division of Responsibilities b/w NCI CIRB and Signatory Institution (Attach 2B)	Form and Instruction
2B Authorization Agreement and Division of Responsibilities 2B_AuthAgreement_DofR_REV.doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	2B	Authorization Agreement and Division of Responsibilities between CIRB and Signatory Institution REV	2B_AuthAgreement_DofR_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: 340

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	340	340
Annual IC Time Burden (Hours)	170	170
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.