Application Forms for the NIDA Summer Research Internship Program

Forms and Documents

Document Name	Status
Form 1 Student Application Form Undergraduates Form and Instruction	New
Form 1 Student Application Form High School Students Form and Instruction	New
Supporting Statement A -Final--1.doc Supporting Statement A	2016-02-10
30-day FRN 2016-02446.pdf Supplementary Document	2016-02-09
Attachment 3-Privacy Act Memo.pdf Supplementary Document	2016-02-03
Attachment 2 - Example of drop-down Menus.docx Supplementary Document	2016-02-03

IC Document Collections

IC ID	Document Title	Status
219962	Student Application Form Undergraduates Form and Instruction	New
219961	Student Application Form High School Students Form and Instruction	New

ICR Details

OMB Control No: 0925-0738	ICR Reference No: 201602-0925-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Application Forms for the NIDA Summer Research Internship Program
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/24/2016
	Date Received in OIRA: 02/10/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved
Responses	350	0	0
Time Burden (Hours)	350	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request for approval of an existing Collection that is in use without an OMB Control Number. It was discovered that application forms for the NIDA Summer Research Internship Program were being used without OMB Clearance from the Paperwork Reduction Act, in 2015 and in earlier years. The National Institute on Drug Abuse (NIDA), the National Institutes of Health (NIH), seeks to rectify this by applying for clearance for the application forms for this program so that the information collection for this program will be in compliance with the Act from now on. These applications are essential to the administration of these training programs as they enable NIDA to determine the eligibility and quality of potential awardees; to assess their potential as future scientists; and to make decisions regarding which applicants will be proposed and approved for traineeship awards.

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Authorizing Statute(s): US Code: 42 USC sections 241 and 282(b)(13) Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 53164	09/02/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 6874	02/09/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Student Application Form Undergraduates	1	Attachment 1 Student Application Form
Student Application Form High School Students	1	Attachment 1 Student Application Form

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	350	0	0	350	0	0
Annual Time Burden (Hours)	350	0	0	350	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: new collection existing without OMB number

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Annual Cost to Federal Government: $361,896

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/10/2016

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