Information Collection

Expanded Access Records - Updates

IC 225089 under ICR 201701-0925-002 · OMB 0925-0586.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0586 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5 Expanded Access Records - Updates	Form and Instruction
5 Expanded Access Record Data Element Definitions (referen Attachment 3 - Expanded Access Record Data Element Definitions (Reference Document) and Data Entry Forms (Screenshots).pdf	Form and Instruction

IC Title:

Expanded Access Records - Updates

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

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	5	Expanded Access Record Data Element Definitions (reference document and data entry forms (screenshots))	Attachment 3 - Expanded Access Record Data Element Definitions (Reference Document) and Data Entry Forms (Screenshots).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 213

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	426	426
Annual IC Time Burden (Hours)	107	107
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.