Statement of Investigator (Attachment 3A, 3B or 10)

Investigator Registration and Financial Disclosure for Investigational Trials in Cancer Treatment (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0613 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Statement of Investigator (Attachment 3A, 3B or 10) Form and Instruction
1 Statement of Investigator CTEP Attach_3A_Statement of Investigator_CTEP.pdf Form and Instruction
2 Statement of Investigator DCP Attach_3B_Statement of Investigator_DCP.pdf Form and Instruction
3 Statement of Investigator Online Attach_10_NCI OCR Screen Shots.pdf Form

Information Collection (IC) Details

IC Title:	Statement of Investigator (Attachment 3A, 3B or 10)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Statement of Investigator CTEP	Attach_3A_Statement of Investigator_CTEP.pdf	No	No	Printable Only
Form and Instruction	2	Statement of Investigator DCP	Attach_3B_Statement of Investigator_DCP.pdf	Yes	Yes	Fillable Fileable
Form	3	Statement of Investigator Online	Attach_10_NCI OCR Screen Shots.pdf	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 National Institutes of Health (NIH) HHS/NIH/OD"	FR Citation: 67 FR 60776

Number of Respondents: 20,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 30 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-20,200	20,200
Annual IC Time Burden (Hours)	-5,050	5,050
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.