Information Collection

Students

IC 220821 under ICR 201603-0925-006 · OMB 0925-0602.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0602 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2 Students	Form and Instruction
2 Attachment 1 Physician and Student Surveys Attachment 1 Physician and Student Surveys.pdf	Form and Instruction

IC Title:

Students

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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	2	Attachment 1 Physician and Student Surveys	Attachment 1 Physician and Student Surveys.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-25-0014 Clinical Research: Student Records

FR Citation: 67 FR 60741

Number of Respondents: 415

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	415	415
Annual IC Time Burden (Hours)	138	138
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.