Information Collection Request

Information Program on Clinical Trials: Maintaining a Registry and Results Databank (NLM)

ICR 201701-0925-002 · OMB 0925-0586 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Initial Registration Data Entry Form Form and Instruction Modified Available
Form 5 Expanded Access Records - Updates Form and Instruction New Available
Form 5 Expanded Access Records - Initial Form and Instruction New Available
Form 4 Extension Requests and Appeals Form and Instruction New Available
Form 3 Certification to Delay Results Form and Instruction New Available
Form 2 Update Results Information of Non-regulated Submissions Form and Instruction New Available
Form 2 Initial Results Information of Non-regulated Submissions Form and Instruction New Available
Form 2 Update Results Information of Non-regulated Submissions related to NIH policy Form and Instruction New Available
Form 2 Initial Results Information of Non-regulated Submissions related to NIH policy Form and Instruction New Available
Form 2 Results Triggered by Voluntary Submission Form and Instruction New Available
Form 2 Updates Form and Instruction New Available
Form 2 Initial Results Information Submission Form and Instruction New Available
Form 1 Updated Registration of Voluntary Non-regulated Submissions Form and Instruction New Available
Form 1 Initial Registration of voluntary and Non-regulated Submissions Form and Instruction New Available
Form 1 Updated Registration of Non-regulated Submissions related to NIH policy Form and Instruction New Available
Form 1 Initial Registration of Non-regulated Submissions related to NIH policy Form and Instruction New Available
Form 1 Registraion Triggered by Voluntary Submission Form and Instruction New Available
Form 1 Updates Form and Instruction New Available
Form 4 Extension Request Form and Instruction Removed Available
Form 3 Certification to Delay Results Form and Instruction Removed Available
Form 2 Result Submission Updates Form and Instruction Removed Available
Form 2 Initial Results Submission Form and Instruction Removed Available
Form 1 Registration Updates Form and Instruction Removed Available
Form 1 Initial Registration Form and Instruction Removed Available
Attachment 8 - Privacy Act Review.pdf Supplementary Document Uploaded 2017-01-09 Available
Attachment 4 – Results Information Data Element Definitions (Reference Document).pdf Supplementary Document Uploaded 2017-01-09 Available
Attachment 1 - Registration Data Element Definitions (Reference Document).pdf Supplementary Document Uploaded 2017-01-09 Available
ClinicalTrials gov Supporting Statement Final.docx Supporting Statement A Uploaded 2017-01-06 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
6153 Initial Registration Data Entry Form Form and Instruction Modified
225089 Expanded Access Records - Updates Form and Instruction New
225088 Expanded Access Records - Initial Form and Instruction New
225087 Extension Requests and Appeals Form and Instruction New
225086 Certification to Delay Results Form and Instruction New
225085 Update Results Information of Non-regulated Submissions Form and Instruction New
225084 Initial Results Information of Non-regulated Submissions Form and Instruction New
225083 Update Results Information of Non-regulated Submissions related to NIH policy Form and Instruction New
225082 Initial Results Information of Non-regulated Submissions related to NIH policy Form and Instruction New
225081 Results Triggered by Voluntary Submission Form and Instruction New
225080 Updates Form and Instruction New
225079 Initial Results Information Submission Form and Instruction New
225077 Updated Registration of Voluntary Non-regulated Submissions Form and Instruction New
225076 Initial Registration of voluntary and Non-regulated Submissions Form and Instruction New
225075 Updated Registration of Non-regulated Submissions related to NIH policy Form and Instruction New
225074 Initial Registration of Non-regulated Submissions related to NIH policy Form and Instruction New
225073 Registraion Triggered by Voluntary Submission Form and Instruction New
225072 Updates Form and Instruction New
185102 Extension Request Form and Instruction Removed
185097 Certification to Delay Results Form and Instruction Removed
185096 Result Submission Updates Form and Instruction Removed
185095 Initial Results Submission Form and Instruction Removed
185094 Registration Updates Form and Instruction Removed
185093 Initial Registration Form and Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/29/2020 36 Months From Approved 11/30/2018
210,037 0 224,530
1,072,306 0 682,535
0 0 0





Reginfo record details
18
table that charts list of burden
IC Title Form No. Form Name
Initial Registration Data Entry Form 1 Registration Data Entry Forms screenshot
Initial Registration 1 ClinicalTrials.gov Registration Data Entry Screen Shots
Registration Updates 1 Registration Data Entry
Extension Requests and Appeals 4 Request for the Extension of the Results Information Submission Deadline (Reference document and Screenshots of Data Entry Forms)
Result Submission Updates 2 ClinicalTrials.gov Results Reporting Data Entry Screen Shots
Certification to Delay Results 3 Certification Form
Registraion Triggered by Voluntary Submission 1 Registration Data Entry Forms screenshot
Initial Registration of Non-regulated Submissions related to NIH policy 1 Registration Data Entry Forms screenshot
Updated Registration of Voluntary Non-regulated Submissions 1 Registration Data Entry Forms screenshot
Certification to Delay Results 3 Certification to Delay Submission of Results Information (Reference Document and Screenshorts of Data Entry forms)
Updated Registration of Non-regulated Submissions related to NIH policy 1 Registration Data Entry Forms screenshot
Updates 2 Results Information Submission Data Entry Forms (screenshots)
Results Triggered by Voluntary Submission 2 Results Information Submission Data Entry Forms (screenshots)
Initial Results Information of Non-regulated Submissions related to NIH policy 2 Results Information Submission Data Entry Forms (screenshots)
Updates 1 Registration Data Entry Forms screenshot
Initial Results Submission 2 ClinicalTrials.gov Results Reporting Data Entry Screen Shots
Extension Request 4 Extension Request
Expanded Access Records - Initial 5 Expanded Access Record Data Element Definitions (reference document and data entry forms (screenshots))
Initial Registration of voluntary and Non-regulated Submissions 1 Registration Data Entry Forms screenshot
Update Results Information of Non-regulated Submissions related to NIH policy 2 Results Information Submission Data Entry Forms (screenshots)
Initial Results Information of Non-regulated Submissions 2 Results Information Submission Data Entry Forms (screenshots)
Update Results Information of Non-regulated Submissions 2 Results Information Submission Data Entry Forms (screenshots)
Expanded Access Records - Updates 5 Expanded Access Record Data Element Definitions (reference document and data entry forms (screenshots))
Initial Results Information Submission 2 Results Information Submission Data Entry Forms (screenshots)

table that charts list 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 210,037 224,530 0 -14,493 0 0
Annual Time Burden (Hours) 1,072,306 682,535 0 389,771 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No