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Federal forms, ICRs, and supporting documents

Information Collection

Attach 1D - Optional Form 1 - Withdrawal from Protocol Participation Form

IC 195156 under ICR 201604-0925-004 · OMB 0925-0624.

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Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Attach 1D - Optional Form 1 - Withdrawal from Protocol Participation Form
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 4 Optional Form 1 - Withdrawal from Protocol Participation attachment_1d_wd.pdf Yes Yes Fillable Fileable Signable

Health Health Care Services

Clinical, Basic and Population-based Research Studies of hte National Institutes of Health (NIH), HHS/NIH/OD  67 FR 60776

50 16
   
Individuals or Households
 
   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 600 0 0 0 0 600
Annual IC Time Burden (Hours) 50 0 0 0 0 50
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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